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NRHM SERVICES
COMMUNITY
MONITORING AND
PLANNING
[ PILOT PHASE ]
TAMILNADU - A IN-TERIM REPORT
[FOR THE PERIOD MAY 2007 - JAN 2008.]
State Nodal Organisation
TAMILNADU SCIENCE FORUM, Chennai - 600 0086.
Facilitated By
MAKKAL NALAVAZHVU IYAKKAM
1
Introduction:
This pilot project was initiated in Tamilnadu vide a two days preparatory meeting held on
30th & 31st May 2007 with the health activists and AGCA Members. Tamil Nadu Science
Forum was unanimously chosen to be the state nodal NGO with suggested list of districts to
be chosen and a group of state mentoring committee members.
STATE LEVEL PREPARATORY MEETING
Date: 30 & 31 /05/07
Time: 10:00 AM - 6:00 PM
Venue: Balamandir Resource Center
Participants:
•
•
Civil Society Groups
Members Of AGCA
The two dav preparatory meeting started with a brief summary of the processes in Tamilnadu
over the AGCA project for the past one month. The participants self introduced themselves.
Rakhal Gaitonde summarized the proceedings of the first meeting held on 11 May 2007 to
discuss the community monitoring project.
The Community Monitoring Project - Ruth Vivek, Center for Health and Social
Justice.
Ms. Ruth Vivek from CHSJ, the Secretariat of the community monitoring project provided an
overview of the project to the participants. She stressed on how to build on the positive
features of the project like the involvement of the panchayat personnel and also the tri partite
link between the health ministry, community and the civil society groups. She briefed the
group about the duration of the project, the role of the constituent members etc. The national
secretariat would help in developing the required tools, protocol, training manual and IEC
materials and also offer guidance in selection of the mentoring team, the nodal NGO etc.
Later she went on to describe the status of the other 7 states involved in the project.
Discussions:
The following were the points highlighted during the group discussion.
=> The socio-political situation of the state may influence the community monitoring
process. Therefore each of the eight states may have its own dimensions. The project
offers flexibility to mould the process and strategy accordingly.
The first step in the process is to monitor the existing guaranteed services and later
build on it to recommend alternate suggestions for changes.
—s The redressal mechanism of the public health sector needs to be strengthened.
=> IEC materials need to be translated in regional language for wider circulation and
awareness generation. Public must not be ignorant of their rights. The material must
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be developed in a simple format using a “rights” perspective. There is a dearth of
knowledge due to lack of information in regional languages. Most of the information
in available on the website making it inaccessible to a wider section of people in the
villages.
=> The National Secretariat agreed to provide guidelines and information which could
later be translated to Tamil.
=> The gaps in the system must be addressed in a positive manner through a public
public partnership based on the principle of equity.
=> It is necessary for the team involved in the project to repeatedly read and understand
the project plan, more specifically the district plan for a smooth implementation.
=> This information gathered through the monitoring process can be used at various
levels for monitoring the public sector services.
=> Media must be involved at all levels in the process. It is essential for documenting the
initiatives as well as to use it as a tool in disseminating information to the public.
Press meet, press releases must be organized whenever necessary.
=> Each district will exhibit unique characteristics therefore planning; setting of goals
must be specific for each district and not based on a common framework.
=> There was a discussion on whether to select districts that had low health indicators, or
are socially backward. Some participants suggested to include both low performing
and high performing states or choose blocks that were socially backward than the rest.
Nodal NGO suggested
Tamil Nadu Science Forum was unanimously chosen to be the nodal NGO
Districts Suggested by Civil Society Groups:
1. Kanyakumari / Tuticorin
2. Trichy/Perambalur
3. Vellore
4. Thiruvallur
5. Virudhunagar
6. Theni
7. Cuddalore
The first 4 districts were the top priority of the group.
Members Suggested for the State Mentoring Team
Representatives of the Implementation Group
• Prof. Rajamanickam (As representative of Nodal NGO) - Convenor
• Fr. Joseph Justus
Representatives of Human Rights Groups
• Ms.Sudha Ramalingam
• Mr.Ossie Fernandes
• Mr. Selvaraj
Representatives of Academic Institutions
• Ms.Padmini Swaminathan
3p i
Represenatatives from Medical Field
• Dr. Chandra
Representatives from Networks
• Ms.Saulina Arnold
• Ms.Vasuki
Represenatives for Marginalised Sector
Ms.Fathima Bernard
Permanent Invitee — Dr.Rakhal Gaitonde (Member of Pilot Implementation Subgroup
AGCA)
The following were ‘Requests’ to the Health Secretary for Immediate Action
•
•
•
•
•
•
•
To designate a nodal official in Government to interact with project implementation
team.
Request to include DPH in mentoring team.
To make all NRHM guarantees and policy documents available in Tamil.
To display these in prominent places proactively.
To designate a redressal mechanism for issues brought up during monitoring.
To issue GO - regarding - Nodal NGO; Districts chosen; Mentoring Team.
To issue a follow up letter with details of project to districts.
Representatives who met the Joint Secretary and Secretary, MoHFW. TN
1. Dr. Thelma Narayan, AGCA member
2. Dr. P. Chandra, TNHDF & MNI
3. Fr. Justus, VHAK
4. Prof. Rajamanickam, TNSF
5. Ms. Sona Sharma, PFI
6. Dr. Rakhal, Task force member, CHC
7. Ms. Saulina Arnold, TNVHA
8. Dr. Ruth Vivek V., CHSJ
9. Mr. Ameer Khan, CHC
10. Ms. Asha, CHC
Meeting with the Joint Secretary, MoHFW. TN, Mr. Thangamani
•
•
Dr. Thelma introduced the community monitoring process under NRHM
Joint secretary proposed a meeting with all the concerned authorities
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Meeting with the Secretary, MoHFW, TN, Mr. V. K. Subburay IAS.
•
•
•
•
•
•
•
•
•
•
•
Dr. Thelma gave a brief overview of the community monitoring process under
NRHM
Dr. Rakhal elaborated on it
Secretary asked the group to inform the DPH and then he will issue a GO
He had no problems with the selected districts
When asked about his availability for the state-level workshop, he said to give him the
dates and he will come
He agreed to prepare booklets on NRHM for the common people to make them aware
of the facilities available under NRHM
He would also get the Framework for Implementation of NRHM translated in Tamil
He said that even the health officials are unaware of the NRHM document so
translating will help in this regard
He said that already monitoring committees have been formed at the village, PHC,
block and District levels
He mentioned that activities under NRHM have been started. Two of the hospitals are
being strengthened to become centers of excellence. Staff Nurse are being provided
for 24 hours to PHC’s. Rs 6000 is being given to BPL, pregnant women which is the
highest amount given to a pregnant woman in the whole country. Due to this
institutional delivery has increased. This has been documented and is sent to the Gol
and they further disseminate the information. In Tamil Nadu, whenever a new project
has been started, its been implemented at a faster rate than other states. Nutrition
status of the state has also improved
When asked about the grievance redressal mechanism, he said that the district
Medical Officer have the powers to deal with that.
Representatives who met the Joint Secretary and Secretary, MoHFW, TN
1.
2.
3.
4.
5.
6.
7.
8.
Dr. Thelma Narayan, AGCA member
Dr. P. Chandra, TNHDF & MNI
Ms. Sona Sharma, PFI
Dr. Rakhal, Task force member, CHC
Ms. Saulina Arnold, TNVHA
Dr. Ruth Vivek V.,CHSJ
Mr. Ameer Khan, CHC
Ms. Asha, CHC
Meeting with the Director of Public Health, MoHFW, TN, Dr. Padmanabhan
•
•
Dr. Rakhal gave the brief introduction to community monitoring process under
NRHM
DPH suggested including Dharmapuri district and he suggested instead of selecting
Kannyakumari and Trichy some other districts could be selected.
In the second day, (31 May’07) meeting members were discussed the framework of the
program. During the meeting based on Direcotr of Public health services, suggestion the
important decision taken was Dharmapuri can be included as fifth district, Kanniyakumari
will be retain and instead of Trichy district, Perambalur was chosen.
5 |
Choosen Districts :
•
•
•
•
•
Dharmapuri
Kanyakumari
Perambalur
Vellore
Thiruvallur
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6 | P a g e
The project of this nature is in partnership with the Community, Government and the
Panchayati Raj institutions will be a valuable step towards increasing the accessibility and
effectiveness of health services to the people. Considering the importance of tripatriate
partnership the group decides to meet all the stakeholders to bring their involvement inthie
process. After a continuous followup with the group with state health officials, the
Government order has released. This process helped us to devlelop rapport with the officals.
During the process of issuing Government order, the design of the program had undergone
few changes and many activities had carried out at the field level. Few activites are worth
mentioning here.
1. Prior to get the G.O there were 10 meetings at the district level, two meetings at each
district held before the state workshop. The objective of those meeting is, to
familiarize the people and the facilitators about NRHM and the project. Many of these
meetings attended by the project core team and those who had attended the TOT at
New Delhi.
2. Most of the work including appointing District coordinator, choice of Block level
NGOs, identification of Block PHCs and identification of Villages were done.
3. All the districts had already met or attempted to meet the relevant government
officials, but since the government order had not yet come, the government officials
were hesitant to participate.
4. We were continuously touch with the state officials and had appraised them about the
various processes proposed.
Given this background, when the government order came in the middle of November 2007, it
was decided in the State Mentoring Committee Meeting held on 2nd December 2007 that not
to have separate workshop and TOT but rather restrict the workshop to a formal inauguration
of the program in the state and combine it with the TOT.
Apart from this the feed back, especially from Dr. Ajay Khare from MP, and from our
partners at the district level, regarding the difficulties faced by having a TOT for a full 5 days
were taken seriously. We thus decided to have a three-day state level meeting, a two day
district level meeting in every district, a one day block level meeting in all the blocks as well
as more block level meetings as the district and block level NGOs feel.
The following is a description of the three day program which was a combination of both the
TOT and the Workshop held in Tamil Nadu.
71
age
NRHM’S SERVICES
COMMUNITY BASED MONITORING & PLANNING (PILOT)
__________________________ TAMILNADU STATE__________________________
State Nodal Organisation : Tamiinadu Science Forum, Chennai - 600 086.
Facilitated by:
Makkal Nalavazhvu
lyakkam
STATE WORKSHOPS
AND TOT -REPORT
Venue : Jawaharlal Nehru Stadium Meeting Halt Chennai
Time : 10.00 am - 5.00 PM
Date : 3rd December to 5th December 2008
Attendees: 60 Persons
❖ State Mentoring Committee Members
❖ State Faclitators & Resource Persons
❖ Government Officials
❖ State / District/ Block Coordinators
❖ District Representatives
AND
❖ Block Representatives
Guests:
■
Shri. Subburaj IAS, Secretary, Ministry of Health and Family Welfare, TN
■
Selvi. Apoorva IAS, State Director, NRHM, TN
■
Dr.Ilango, Joint Director, Gen. Health and Preventive Medicine, DPH
■
Dr. Prabhu Climent Devadoss, Nodel Officer, CMP
Resource Persons:
•
Dr. Regi, Sittilingi, THI
•
Dr. Chandra, State Mentor
•
Dr. Jasmine, CMC, Vellore
•
Ms. Nirmala, President VHN Association of TN
•
Ms. Jennat, Secretary VHN Association of TN
•
Mr.Selvaraj, Joint Secretary, PUCL
•
Mr. Kannaiyan, Convenor Right to Food Campaign, HRLL
8I
Programme Schedule:
SESSION
TIME
_____
RESOURCE PERSON
I
INTRODUCTION AND INAUGURATION
Welcome address
!____________________________
s<
Mrs. T.Shanti, Proj. Coord,
TNSF__________________
Presidents address
P. Rajamanickam, Convener
State Mentoring Committee,
TNSF
_________
! Spl. Guest’s Inaugural Address (1)
Selvi Apoorva IAS
PD, NRHM, GoTN
Spl. Guest’s CMP Address (2)
i AGCA member
; Spl. Invitees (1)
Dr. Elango, Joint Director, DPH
Community Monitoring perspectives from the field - (ANM) - (10 mins)
■ Ms. Nirmala
i------------------------------------------------------------------- —-----------
]________________ j
Dr. Ravindranath to suggest
Community Monitoring perspectives from the field - (Govt. Doctor) (lOmins)
<
Q
Community Monitoring - perspectives from the field - Mr. Vishwanathan, Vellore
Block
(PRI representative) - (10 mins)
Community Monitoring - perspectives from the field - Mr. Kannaiyan
(Civil society representative) - (10 mins)
Community Monitoring - response from MoH-lOmins From GoTN - MoHFW
Dr. Prabhu Clement
Nodal Officer, NRHM
Community Monitoring - response from NRHM (10
mins)
Community Monitoring - response from RD (10 mins) From GoTN - MoRD
Suresh, Joint. Proj. Coord. CMP,
Vote of Thanks
Introduction about the Program in TamilNadu-20Mins Suresh, Joint. Proj. Coord. CMP,
O
Ameer, CHC
Time line of the project (1 hour).
- outputs, origin^ time lines, time left, what is doable
£2 § Structures and Processes within the project
)—I
3I
<
Q
Rakhal, CHC
Start - up Session (54 hour)
Ameer / Suresh
Committee formation - small group discussion and
plenary presentation of groups with comments by
resource person
(30 mins - discussion, 30 mins - presentation,
20 mins - open discussion, 10 mins - wrap up and
inputs from resource person).
Facilitation Rakhal, PR, Fr. Justus
Preparation of the village report card
(30 mins - discussion, 30 mins - presentation
20 mins - open discussion, 10 mins - wrap up and
inputs from resource person).
Shanti Dani
Ameer
Shanti
!
9 |
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Q
Introduction to Tools for monitoring (30 mmins)
Rakhal
Study of the tools in groups - district wise.
(1 !6 hours)
Facilitation - Dist. Coord's
Feed back from the participants about the tools.
(1 % hour)
s Jasmine, Rakhal
Dr. Chandra, State Mentor
I Francis, State Mentor
Start - up Session (Vi hour)
Ameer / Suresh
Approaching and interacting with government
officials. (20 mins)
SureshPUCL
Approaching and interacting with PRI representatives Mr. Amal Das
i (20 mins).
i Training for the committees presentation
|(1 hour 10 minutes)
!
Plan of Action - dictrict wise groups - worksheet
based activity.
(1 hr group discussion 15 mins per group
§
3 2 u presentation-75 min, Ihour discussion and
i’ Q
clarification)
■
1
! m H K
U
P. Raj amanickam
: Shanthi and Ameer
PR
Suresh
Ameer
Shanti
Shanti Dani
Venue and Participants:
The workshop was residential (to facilitate the interaction of participants post workshop) as
well as to allow for the workshop to go on late into the evening. It was held at the Jawaharlal
Nehru Stadium - conference hall, Chennai.
A total of 62 persons attended the workshop on all the three days. These included nearly 50
individuals from the 5 districts in which the project is going to be implemented.
The program:
The program was broadly divided into 6 half day sessions. The details of these sessions were
as follows.
Session I - Dav one AM - this was the formal state workshop with the primary objective of
inauguration of the project in the state. It was attended by the Project Director of the National
Rural Health Mission in the state, representative from the Directorate of Public Health, the
Nodal officer from the ministry of health designated to liase with the project, technical
consultants to the NRHM directorate and the president of the Tamil Nadu Village Health
Nurses association, apart from representatives from the State Nodal NGO in Tamil Nadu Tamil Nadu Science Forum, Representatives from the district level mentoring committees,
representatives of the state mentoring committee, members of the Makkal Nalavazhvu
lyakkam ( the Tamil Nadu chapter of the People’s Helath movement). Community Health
Cell (which is providing technical consultancy), Christian Medical College, department of
Community health and development and a few private practitioners who were also members
of their local professional body associations.
10 | P 2- g G
Session 2 - Dav on Post lunch - this session focussed on the National Rural Mission, its
highlights, Community monitoring in the NRHM, the project so far in Tamil Nadu etc. The
session also introduced the participants to the various structures being introduced (or which
were being strengthened) and the various processes that were to be accomplished during the
project period. The importance of the pilot nature of the project was also stressed.
Session 3 - Day two AM - During this session there was a sharing of the various types of
monitoring work the participants were already involved in / or had been involved in. This was
to bring home the fact that the project is not entirely new to the group and that they had a lot
to contribute to the overall design and implementation of the project as it folded out in Tamil
Nadu. After this sharing the participants were introduced to the tools - the participants in
groups as per their district sat and read through the tools.
Session 4 - Dav two Post lunch - During this session there was feed back from the
participants regarding the tools. There was also a discussion regarding the process of
committee formation and the working and setting up of these committees. These sessions
were small group discussions that were facilitated by a worksheet with specific questions
(Appendix II for examples)
Session 5 - Dav three AM-There was more discussion on committee formation, the process
at the village level, the logistic details etc. There was also a session by persons involved with
the social auditing process of the Right to Food Campaign - on approaching and interacting
with the government officials and PRI representatives.
Session 6 - Day three Post Lunch - The final session of the workshop was dedicated to
detailed planning of the way forward - again in small groups according to the district. The
district (again with worksheets) committed to processes, dates and responsibilities. The
workshop ended with a participant feedback.
Simultaneously the project coordinator at the state level had separate discussions with the
district nodal NGO representatives, and the district coordinators (together and separately) to
discuss the issues of logistics, accounts, reporting, fund flow etc.
Report in detail:
Session I-Day one AM
The workshop was inaugurated by Selvi. Apoorva IAS., the Project Director of the National
Rural Health Mission in Tamil Nadu.
At the outset Mr. Ameer Khan Co-convenor , Makkal Nalavazhvu lyakkam and Community
Health Cell welcomed all the participants to the workshop. He briefly touched upon the fact
that health and health care were a fundamental human right, and this community monitoring
project may be seen as step in realizing this. He also thanked the government for releasing the
government, and appointing a nodal officer for liasing with this project.
111 P a g e
Prof. Raja Manikkam, Convenor of the State Mentoring Committee and from Tamil Nadu
Science Forum then delivered the Presidential Address. In the address he highlighted the
various components of the National Rural Health Mission. He also highlighted the
importance of community monitoring, and noted that this was a very positive step on the side
of the government. It was now upto the people and civil society to use these spaces created by
the government for effectively monitoring these services. He also gave a brief overview of
the various committees, their functions and their potential use.
In her inaugural address, Selvi Apoorva IAS said that the National Rural Health Mission was
focussing on strengthening health care services for the rural people. She said that a program
like the community monitoring and planning program that she was inaugurating today should
aim at increasing the community demand for government health care services. It was only
when there is demand that the services become more efficient. She said that another aspect
that the implementation of this project was expected to increase was community
participation. She hoped that through this project there would be an increased community
ownership of the public health care system. She also said that such community based
activities, when coupled with functioning government services could realistically reduce
maternal mortality. She sincerely hoped that this would happen.
In her response to the Community Monitoring and Planning Program Ms. Nirmala, President
of the Tamil Nadu Village Health Nurses Association said that till now there used to be only
internal monitoring of work. In this officials, mostly the seniors in the department, would
come for monitoring. She said that this concept of the communities monitoring the
functioning of the health care services was new. She said that the Village Health Nurses
association would definitely welcome this process. She mentioned however that the general
public had very little idea about what services were available, when they can be accessed,
who is eligible for these services etc., this lack of knowledge may lead to under utilization of
services or to misunderstanding — with people presuming that the service is not being
provided when in-fact they are not eligible, or the service provider is at another location
providing the service etc. She also mentioned that there was a very extensive and well
thought out infrastructure present, and very innovative schemes, however the problem was in
the actual implementation, with many genuinely poor persons loosing out due to red tape. She
also highlighted the various problems the Village Health Nurses face during their work.
Dr. Prabhu Clement the Nodal Officer for this program then gave a detailed presentation on
the various concepts of monitoring. He underlined the fact that the whole process was
supposed to be a joint effort. He said that making it confrontational would make it loose its
innovativeness and its capacity to bring about change. He described the difference between
supervision and monitoring. He stressed that monitoring was not a one time event, it was
continuous observation of the functioning of the services. Unless one observes the
functioning in detail one cannot understand the problem from all its angles, and unless one
understands the problem from all the angles one cannot hope to bring about positive change.
He like the earlier speakers also stressed that there needs to be a concerted attempt at
increasing the awareness levels of the people regarding the various services available in the
public health system.
The session was brought to a close by Prof. Krishnaswamy, President of Tamil Nadu Science
Forum, who welcomed the whole initiative, and hoped that this would bring about a
measurable increase in the health of the people of Tamil Nadu.
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Session 2 - Day One Post Lunch
The post lunch session started with a presentation by Ameer Khan on the history of the
People's Health Movement, the Jan Swasthya Abhiyan in India and the Makkal Nalavazhvu
lyakkam in Tamil Nadu. He especially mentioned the betrayal of the dream of health for all,
the decision by various groups working on health in the late 1990s that people's health must
be in people’s hands. He spoke about the preparatory activities all over the world that lead up
to the first People's Health Assembly held in Savar, Bangladesh. He also mentioned the
preparatory activities in Tamil Nadu as part of the Indian preparation that culminated in the
first National People's Health Assembly in Kolkata. He also mentioned the Cuenca - 2nd
People's Health Assembly as well as the 2nd National Poeple's Health Assembly in Bhopal in
2007.
Subsequently Dr. Rakhal of Makkal Nalavazhvu lyakkam Tamil Nadu secretariat and
Community Health Cell gave a detailed overview of the National Rural Health Mission. He
reiterated the stated goals, the 5 key approaches including He specifically highlighted the strengthening of the public health care services by the
development of Indian Public Health Standards. He also mentioned the various monitoring
and planning committees at different levels and the expected role of the Panchayati Raj
institutions. He saw this as one of the most important spaces available to the community in
this program. He mentioned that this space was something all of us have been struggling for
in various ways and forms. He felt that this opportunity cannot be left by the way side. As
this was a pilot project, there was a good chance that our experiences would feed into a
national process to finalize the overall protocol and tools. He also mentioned the introduction
of the Patient Welfare societies at different health care institutions, their significance, and the
funding for these. He felt that one of the most important innovations of the National Rural
Health Mission was the introduction of untied funds at various levels. This not only gave
flexibility, but also potentially increased ownership by giving the committees at various
levels some importance and feeling of responsibility.
During his talk he also touched upon the main features and details of the present Community
monitoring and planning project. He stressed the process part and felt that we need to focus
more on the process and awareness building rather than any specific indicators which will be
expected to take much longer to reflect change. However he did feel that we should keep
ourselves some clear goals that will be felt as useful to the community and that is easily
achievable. Moreover he also stressed that while doing the project we need to keep in mind
that in the long run this process is to be done by every community, many of whom may not
have the support of the civil society groups as in the present project. Thus the protocols and
tools and processes we envisage needs to keep this in mind.
Mr. Selvaraj, State mentoring committee member then made a presentation on trying to under
stand the process of monitoring. He first highlighted some of the basic issues of health. The
fact that health was a fundamental human right. The fact that health care should be available
to all regardless of ability to pay. He also talked about various ways to increase the
participation of communities. He specifically mentioned that all this needs to be done in the
backdrop of a struggle against privatization. He also mentioned the problems faced by the
people due to this move towards privatization.
13 | Pae
Dr. G Kolandaivel Pandian then gave a lucid presentation on the various social determinants
of health. He highlighted the following specifically: the importance of health related
awareness among the people; the common health related problems faced; the importance of
the formation and strengthening of the various committees; the strengthening of the various
institutions delivering health care. At the same time he also highlighted the importance of
good food; protected and purified drinking water; toilets and adequate hygiene and sanitation;
livelihood; regular income; womens education; access to basic health services etc.
Session 3 - Dav two AM
The morning session started with a round of open sharing about the various experiences each
member of the audience had had with community based monitoring.
Mr. Aral of Jeevajothi recounted their experiences of forming village watch dog committees.
Apart from involving the various panchayat representatives, ward members, senior respected
persons etc. they also involved the actual beneficiaries of the program. This was done
especially to ensure direct feedback regarding the services. Thus the school based monitoring
was done through the PTA committee, the ICDS monitoring was done through the mothers
group. This ensured interest and ownership of the monitoring.
Fr. Justus talked about the importance of face to face accountability in the planning of
accountability mechanisms. He mentioned how for a member of parliament for example there is no real accountability as he is supposed to represent such a large number of people
who are separated by large distances as well as varying needs and priorities. He explained the
concept of neighbourhood level committees and the effectiveness of such a concept and its
working in Kanyakumari.
The representative from Pasumai Trust that works among the migrant workers who come to
work in the brick kilns in the area. She mentioned the horrible conditions under which the
people worked. She mentioned about the long time it takes to organize people and make them
demand their right. She also mentioned the importance of having a government order / law
etc. to quote and organize around. Given the relationship between the workers (many of
whom are bonded) and the owners - it was very difficult to get people to demand their rights.
She talked about their struggles for increase in daily wages, and how it took a lot of time and
convincing before people decided to get together and form a committee and demand their
right. The people required inputs on how to write applications, talk to officials, which rules to
quote etc.
Dr. Chandra mentioned that no single person alone could go and ask questions. However
continued information and organizing will definitely pay good results. She mentioned the
campaign to introduce immediate breast feeding at hospitals as an example of a practice that
has increased not only through health education, but also due to pressure from interested
pediatricians.
Ms. Ninnala of the TNVHNA made a presentation about the various problems from the
perspective of the VHNs. She highlighted the issues of people resistance to health messages.
The FST tablets given during pregnancy was a classic example. No one completely had all
the tablets. She also mentioned that the siddha medicines that were being distributed for
anemia in a few districts were very successful and welcomed by the people, but the program
14 | P a ~ ?
was not being expanded. She also talked about the lack of basic materials at the sub-center
level, there was not even current given to many sub-centers though the VHNs were
performing very well. She also mentioned that many a time crucial posts like a sweeper or
cleaner have not been budgeted and this leads to a lot of problems in the smooth running of
the services. She also mentioned that while the programs like Muthulakshmi Reddy scheme
and JSY were functioning very well, there was an increasing trend for political interference to
get the benefits for rich and politically connected mothers, while genuinely poor and
deserving mothers were being left out. Many of the problems were because the people did not
understand the way the government functioned, this led to a lot of misunderstanding.
Dr. Jasmine suggested that monitoring should be a silent process, where there is detailed
observation of what is happening at the level of the PHC or the Sub-center etc. Based on this
observation detailed reports can be made. Again she felt these reports should be collated and
presented centrally rather than at the local level to avoid direct confrontation between service
providers and clients.
Prof. Rajamanikkam then went over a summarry of all the spaces opened up by the NRHM
scheme. He mentioned the State Health Society, the District health societies, the patient
welfare societies at various levels etc. and mentioned their roles and responsibilities. This
will help in monitoring or even taking part in each of these.
Session 4 - Dav Two Post Lunch
The group then broke up as per districts and read through the tools that were circulated to
them. This extended to post lunch. After lunch the groups each made a presentation of what
the various suggestions for changes in the tools were.
After this session, there was a briefing about the various activities that need to be done at the
block level by the groups. This included the performing of a base line description of the
village, activities to decide the health committee, training of the health committee etc. Dr.
Rakhal and Ameer described these processes in detail. This was followed again by the group
breaking up district wise. They filled in worksheets (Appendix III) to record their plans and
deadlines as well as their plans.
Session 5 - Dav Three AM
In the morning session there was a continuation of the discussion on the formation and the
actual composition of the various committees. There was discussion on the exact definition of
a ’village’ to be taken and about the importance of specifically collecting information from the
dal its Various participants recounted experiences in Tamil Nadu where Dalits were Still
refused treatment in PHCs etc. thus it was important to choose in each district at least one
predominantly dalit village. After a detailed discussion on the logistics and other details of
the project, there was presentation by Mr. Kannaiyan of the Right to Food Campaign - he
described the recently completed Social Audit process in Villupuram district. He highlighted
the various challenges in interacting with officials at various levels including the panchayat
representatives, as well as the special nature of the Right to Food that had the supreme court
orders to fall back on and as a bench mark.
15 | P a g e
Session 6 — Day Three Post Lunch
The final session consisted of two parts. In the first part the participants sat together as
districts and went through the development of a detailed plan of action. Again this was done
with a worksheet (Appendix IV). This was a very good session as the district teams got to
know one another, and had a lot of time to plan together, an opportunity many felt they would
not get back in the districts. The presentation of the plans of action was to a panel consisting
of the Nodal Officer, Fr. Justus, Dr. Chandra and Mr. Shankar.
After a presentation of the individual plans of action, there was a facilitated evaluation of the
whole program, by the participants. In the feedback all the participants felt they had got a lot
of new information and felt quite enthused about going back to the districts and beginning the
project. They all however mentioned that the time line was very ambitious, but however they
would give it their best shot as this was a very good opportunity.
Plan & Schedule:
We come to the following action plan for next three months i.e. from Decemebr 2007 to
February 2008 from the group disscussion made in the workshop with the style followed in
the state workshop.
NO
01
02
03
04
Description______________
2 days wokshop at each
districts
with
the
particiapation of block &
village key activists, officials
and community members
Block Workshop One day wokshop at each
block with the particiapation
of Block and village key
activists,
officials
and
community members
A pilot study on Tools
Pilot Study
evalved in workshops in one
PHC in each district minimal
VHSC Formation Preparatory meeting and
Formation of VHSC in all
villages
Activity
District
Workshop
Units
5 Nos
Time Frame
Deccember 2007
45 Nos
Deccember 2007
- January 2008
(before 14th)
5 Nos
Last week
January 2008
225 Nos
January 20th 2008
— February 2008
of
The Districts and Blocks start to implemet this plan and finishes in time with required
outcome.
16 I
a
e
DISTRICT AND BLOCK WORKSHOPS -REPORT
t>HARMAl‘l,Rl DISTRICT WORKSHOP-TOT REPORT
Venue:
Periyar Mandapam- Dharmapuri.
Date:
26th &27,h Dec’07
Time: 10.00am
Attendees :
1. Mr.KJlavarasan- Director -Arogiam Trust
2. Mr.K.P.Senthilraja- Peoples watch- Dharmapuri.
3. Mr.Dharmaiingam-Director-RDS-Kadathur
4. Mr.saravanan-Director-SEEDS-Nallampalli
5. Mr. Sivakumar-Director-CRDS-Harur
6. Mr.Velmurugan-Director- Dharmaas-Palacode.
7. Participants from NGO Leader, Civil society members, Panchayt
Representatives,Govt, officials ( List Enclosed)
Guest:
1. Mr.G.venkaterswaran- Chairman , District Panchayt- Dharmapuri.
2. Dr.ayyanar-MD, DDHS- Dharmapuri.
3. Ms. A.alphonse Mary J)MCHO, Dharmapuri.
Resource Persons:
1. Mr.Ameerkan-MNI-Chennai.
2. Mr.M.Shankar-president-DHVANI (Dt. Nodal Orgn.)
3. Mr.K.Kamalakkannan, Dt.prog.Co or -CM process —DHVANI.
4. Ms.Krishnaveni- Dt.Secretary-AIDWA, Dharmapuri.
Total Participants : 87 Members.
Panchayt Presidents
9 Members
Ward members
3 members
17 | P 3 g. e
SHG Leaders
28 members
NGO Leaders
22 members
Community’ Leaders
16 members
Youth Leaders
6 members
Guest
3 Members
Agenda :
1.Inauguration
2. Health as Rights an over view
3. Introduction of NRHM & CM
4. Roles & responsibilities of Govt.
5. Health Status in Dharmapuri dt.
6. Formation of Dt. Committee
7. plan of Action .
Tool used:
Training Materials ( scribbling Pad, pen , File , Phamplet)
Thematic address
Experience sharing
Group process
Group presentation.
Methodolgy used:
Participatory Process followed.
Report:
26th Dec’08:
The workshop began with welcome address by Mr. Elavarasn, Director , Arogiam Trust
Dharmapuri.
Mr. M. Shankar, President - DHVANI, delivered an introductory address on NRHM and CM
process and also briefed on the importance of two days workshop. In his address stated that
NRHM is an initiative by the Govt, of India to ensure health to all before 2012. The major
thrust of the programme is to reach the un reached in society.
18 | P -a g 3
Mr. G.Venkateswaran:
The Dt. Chairman delivered a guest lecture and stated that this is a new programme ans the
stakeholders should be participated to make it success. The Dt. Panchayt Administration is
willing to extend its support for the success of the process and assures you that what ever the
support required let me committed to do for the casue.
Dr. Ayyanar, DDHS:
He delivered key note address and shared that what are the activities being carried out in the
District ,and stated that health activities in the district is at the satisfactory level in all aspects
such as .. immunization coverage, Institutional deliveries and HSC functions and formation
of committees at PHC and HSC level. In order to ensure maximum reach out all the VHNS
are having cell phone and the number displayed in front of HSC. To make it 100%
institutional deliveries in tribal areas where the staff are facing problems , suggestion has give
to care the complete family members to stay in the hospital during delivery' period by provide
meals to all the members for all the days especially in Sidheri and Kottapatti tribal area. The
Tribal mobile clinic and emergency Ambulance services are being intensively operating for
the cause. Finally he shared that the health department is willing to extend its support to
make it success and immediately given an order to Medical officers and VHNs to participate
at the block level workshops in the respective blocks.
Ms. Alphonse mary:
She is responsible for district maternal and child health while addressing , few issues had
been focused how the system is functioning the district and the achievement made during the
recent period.
Mr. Ameerkan:
Mr. Ameerkan who is from Makkal nalvazhavu lyakkam , Chennai , narrated the whole
process being developed by the Govt, of India and the roles and responsibilities of the state
health department. The basic inputs by him helped the participants to involve in the workshop
and contributed to strengthen the process.
After an inaugural function , thrust area of the workshop focused by Mr. Ameerkan
elaborately. An hour Thematic speech on health as right sensitized the participants to re act
in the process. Every body felt that this is very much important and monitor the health
activities in the area and very clearly shared that the CM process doesn’t mean to find fault
against the system but strengthen the system to make it reality by reach out to entire
community.
Mr. M.shankar:
He narrated the CM process in the district and the list of blocks, PHCs and coordinating
NGOs in which the pilot phase of community monitoring is to be undertaken was finalised as
follows.
19 |
a g t-
Block
Nallampalli_____________
District coordinator - SEEDS
PHC
Coordinating NGO
Indur_______
Thoppur
Palayanpudur
SEVA
Pothigai__________
SEEDS
Hanir_________________
District coordinator - CRDS
Kotapatti_____
Chinnakuppam
Koothadipatti
CRDS
AWARD
HELP
Karimangalam________
District coordinator - RDS
Jakkasamudran
Hanumanthapuram
Periyampatti
RDS_______
DHARMAAS
Arokiyam
And shared that the formation of different committees at different level to monitor the health
activities in the district. He stressed more on the committee formation and its importance in
strengthening the democratic process and it should be ..bottom up representation.
27th Dec’07:
Mr.Elavarasan:
He took the topic on roles and responsibilities of PHCs and HSCs , he listed out the activities
are being carried out in PHCs and HSCs. The major activities are ..
M.O- PHC:
8 .00am to 11 .00 am op
12 .00 am special cases
5.00 pm field visit one HSC
Dr. Availability Board disply
Attend call duty
Ensure safe drinking water
Endemic Diseases care (If occur )
Patient welfare society Monitoring
VHSC monitoring
Untied funds monitoring
Birth verification
Free birth certificate issue immediately before discharge from delivery.
Friday IEC
Trainings to Community health Volunteers
Lab function
20 | P a
Drug supply monitoring and intend.
24 hrs delivery
3SN
And other duties call by the district administration.
VHN- HSC :
•
8.00 am to 1.00 pm Field visit
•
1.00 to 3.00 pm rest
•
3.00 to 5.00 pm records maintain
•
Prepare FTP ( Field Tour programme)
•
ATP ( Action Tour Programme )
•
Monday- AN Day
•
Tues Day- PHC review
•
Wednesday- Immunisation
•
Thrusday- School health
•
Friday- IEC
•
Saturday- drop out day
•
Govt. Schemes (Muthulakshmi Reddy Scheme and Govt.
Mr.Kamaiakkannan:
He developed the process to be carried out at various level. In this regard few question have
been given to the participants such as..
1.
What are the activities to be monitored
2.
Who all are going to do
3.
How are we going to do
4.
Tool to monitor
The total participants have been divided in to 5 groups and discussed the same with different
perspectives and made charts and presented by the moderator from each group. The process
went on in healthy manner and every dody participated to strengthen their group.
Mr. M.Shankar:
1. Summerised the whole event and proposed to form a committee at the district level.
WTith the opinion of the participants the following members were suggested by the
group to lobby with the district administration. District Level Monitoring Committee.
2. - Nir. Shankar, DEEPS (Dt. Nodal NGO DHVANI President)
- Nir. Senthil Raj, Real Foundation( Human Rights Activist)
211 P s g e
- Mrs. Kanakamma Thavasi, PMNM (Women Leader)
- Mr. Kamalakannan, IRDO ( CM process Dt. Co or )
- Ms.Krishnaveni,( Women Activist )AIDWA representative
- Dr. Ravichandran , TN IMA representative
3. The following names were suggested for the District Mentoring Committee.
- Dr. Regi George, THI - Mr. Uavarasan, Arokiyam
4. The following resolutions were passed:
•
•
•
•
•
Block level workshop should conducted before the end of Dec’07.
Initiate rapport with all stakeholders and shared the process.
Inform to the community and the panchayt rep in the identified area.
Identify the potential and needy people who can contribute for the success
of the process at village level.
Invite all the stakeholders for block level workshop especially the health
personnel and panchayat chairman and representatives.
Mr.Senthil Raja:
The two days programmes has been briefed by him and thanked all the participants and the
state nodal and facilitating organization for provided an opportunitu to initiate the process in
the district.
Signature
Participants:
S.No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
__________ Name
S.Kuppuraj______
P.Tamilselvam
B .Dhanalakshmi
D.Kalapponnu
A.Amsaveni_____
P.Latha_________
S.Deivani_______
S. A. Murugan
S.Saraswathi_____
A.Sekar_________
Kogilavani______
R.Murugan______
D.Ganesan______
G.Surulirajan
Ameerkhan______
P.Malliga_______
P.Santha________
Kamala_________
K.Duraimani_____
R.Drmalingam
A.Saravanan
________________ Address______
Magenthiramangalam (PO)________
Malliguddai (PO)________________
Malliguddai (PO)________________
Toppur (PO)____________________
Modur (PO)____________________
Pagalahalli (PO_________________
Pagalahalli (PO)_________________
SEEDS,Kongavembu,Harur(TK).
SEEDS,Pagalahalli,Dharmapuri(DT).
Pagalahalli (PO_________________
Palvadi________________________
Paparapatti (PO)________________
SEEDS, Nallampatti._____________
DHARMAAS,Palacode.__________
MNVI, Chennai_________________
Pothigai, Pagalahalli (PO)_________
Maniyathhalli (PO)______________
Maniyathhalli (PO)______________
SEVA, Paparapatti (PO)__________
RDS__________________________
SEEDS
22 |
I
4
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
N.Prabavathi_____
N.Uvarajan______
K.Elavarasan
K.P.Senthil______
T.D.Murugaiyan
S. Senthilkumar
M. Vasanthakumar
K.Elavarasan
P.Kuppusamy
A.Rajesh________
T. Sivarangam
D. Latha_________
P.Palani_________
S.Mothilalnerhu
C.Selvaraj_______
P.Karunamurthi
G.Ravikumar
Talith.Govinthan
Padmapiriya_____
Sivalingam______
Sunthari________
Madhammal_____
N. Sakthivel_____
S.C.Kaneshkannan
V.Kaliyammal
M.Maya________
S.K.Sarumathi
Perumal________
M.Murugan_____
RXala_________
Mari___________
Subbulakshmi
S.Amutha_______
Sunthiram_______
Rajakumari______
Pappathi________
G.Rathakishnan
E. Munusamy
S. Sivakumar_____
P.Krishnaveni
K.Ramalingkam
K.R.Annadurai
K.Periyasamy
P.R.Sakthivei
K.Rajalingam
T. Tamarikannan
K. Seivam_______
Kaliyammal
President. Bkkanahalli.________________
Vicepresident_______________________
Arrogiyam., Truest.___________________
Peopls watch, Madurai________________
5/915, Senthil nager.__________________
HELP, NGO, Harm__________________
HELP, NGO, Harur__________________
HELP, NGO, Harm__________________
HELP, NGO, Harm__________________
Youth Group, Barathipuram.____________
Youth Group, Barathipmam____________
PRWDS, Pagalahalli, Dharmapuri_______
President, Mallikudai,Palacode_________
Nallampalli_________________________
AWARD, NGO_____________________
HELP, NGO________________________
Arrogiyam, Truest___________________
Dt. President, Athithiravidarsangam______
Janapriyasai, DashanApts, BGI-67_______
SGH, Jarugu________________________
SGH, Jarugu________________________
Members, Jarugu____________________
Toppm (PO)________________________
Toppm (PO)________________________
Baimakkanpatti (PO)_________________
Kottappatti_________________________
Kottappatti_________________________
Kottappatti_________________________
Palvadi____________________________
Palvadi____________________________
Vettrappatti (PO)____________________
Vettrappatti (PO)____________________
Sembakapoo SGH, Vellanm___________
Sevanthipoo (SGH)__________________
Rojapoo (SGH)______________________
Sevanthipoo (SGH)__________________
Nakkanpatti (PO)____________________
Kammapatti (PO)____________________
CRDS,NGO, Harur___________________
Nakkamar.SGH_____________________
Magenthiramangalam (PO)____________
Karimangalam (PO)__________________
Makkalnala paniyalar, Palavadi Panchayat.
Pannandm (PO)_____________________
Toppamptti (PO)____________________
DEEPS, Pennagaram (TK)_____________
Pagalahalli (PO)_____________________
Sathiyabama SGH, Sonnampatti
23 ) ? a §
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
85
86
87
88
Maachila_______
M.Palanisami
P.Anbalakan_____
K. M.Palani______
S. Gowri________
T. Kanakamthachi
Kasilingam______
Muthuraj_______
C.Ravi_________
V.Baskar_______
L. Thangavel
Munusamy______
S. Rajamma_____
R. Valli_________
Madhammal____
T. Bakkiyam_____
M. Sathiya______
S. P. Vengatesan
Dr.N.Iyyanar
A.Alphonesamary
89
90
N. Kamalakkannan
M. Shankar
Sathiyabama SGH, Sonnampatti
Tippampatti (PQ)________________
A.Murukkampatti ________________
Erumathur (PO)_______________
Seva, NGO_____________________
pmnmZZZZZ2ZZZZZZ2Z
PMNM ______________________
Vice - president_________________
Makkalnalappaniyalar____________
President, Anumanthapuram_______
4th Ward Member
Ward Member______________ _
AIDWA. Dharmapuri____________
AIDWA. Dharmapuri____________
AIDWA. Dharmapuri____________
AIDWA, Arur
~
AIDWA. Dharmapuri____________
Dt. President______________ _
Deputy Director, Health. Dharmapuri
Director Material & Child health
Officer.Dharmapuri______________
Dt. Co-ordinator. NHRM Project
Dr.DHVANI
District map :
Coverage Blocks for Pilot project under CM process in NRHM services in Dharmapuri
District:
Karimangalam
Nallampalli
Harur block
Dharmapuri
Child Sex Ratio(0-6)
Palakkodu
■
harmapurJ
Harur
Papplreddlpatt]
S <= 785"^
E 785.01-808
808.01-831
E 831*01-854
® >= 854*01
Page
©NICJNSC
DHARMAPURI DISTRICT - HARUR BLOCK
Venue : Panchayat Union Meeting Hall, Harur
Time: 10.30 am
Date: 29.12.2007
Attendees :
Participants from NGO Leader, Civil society members, Panchayt Representatives,Govt.
officials (List Enclosed)
Guest:
Mr.Sakkan Sharma -Dt. Panchayat Member & Dt. Planning Committee.
Ms. Rajeswari - BDO- Harur
Resource Persons :
Mr.M.Shankar-president-DHVANI (Dt. Nodal Orgn.)
Mr.karunamoorthi- Director - HELP- Harur
Air.Selvaraj" AWARD- Pappireddipatti
Total Participants : 76Members.
Agenda :
1 .Inauguration
2. Health as Rights an over view
3. Introduction of NRHM & CM
4. Roles & responsibilities of Govt.
5. Health Status in Dharmapuri dt.
6. Formation of Dt. Committee
7. plan of Action .
Tool used:
Training Materials (scribbling Pad, pen, File , Phamplet)
Thematic address
Experience sharing
Group process
Group presentation.
Methodolgy used:
•
Participatory’Process followed.
25 |
d£
Report:
The workshop began with welcome address by Mr. Sivakaumar, Director, CRDS Harur.
Mr. M Shankar. President - DHVANI, delivered an introductory' address on NRHM and CM
process and also briefed on the importance of workshop. In his address stated that NRHM is
an initiative by the Govt, of India to ensure health to all before 2012. The major thrust of the
programme is to reach the un reached in society.
Mr. Sakkan Sharma:
The Dt. Panchayat Member and Dt Planning Committee member delivered a guest lecture
and stated that this is a new programme all the stakeholders should be participated to make it
success. The Panchayt Administration is willing to extend its support for the success of the
process and assures you that what ever the support required let me committed to do for the
cause.
He also pointed out that the health activities in Harur area is not at the satisfactory level, the
officials not even listen the words of the peoples representatives. This is an opportunity to the
peoples representatives to monitor with an order provided by the Govt. The PHCs functions
and care delivery should cared.
Nir. karunaMoorthy:
Director HELP NGO ,narrated the whole process being developed by the Govt, of India and
the roles and responsibilities of the state health department. The basic inputs by him helped
the participants to involve in the workshop and contributed to strengthen the process.
After an inaugural function , thrust area of the workshop focused by Mr. Shankar elaborately.
An hour Thematic speech on health as right sensitized die participants to re act in the process.
Every body felt that this is very much important and monitor the health activities in the area
and very clearly shared that the CM process doesn’t mean to find fault against the system but
strengthen the system to make it reality by reach out to entire community.
He also narrated the CM process in the district and the list of blocks. PHCs and coordinating
NGOs in which the pilot phase of community monitoring is to be undertaken was finalised as
follows.
Block
PHC
Naliampalli______________
District coordinator — SEEDS
Indur_______
Thoppur
Palayanpudur
Coordinating
NGO
SEVA
Pothigai_____
SEEDS
Harar_________________
District coordinator — CRDS
Kotapatti_____
Chinnakuppam
Koothadipatti
CRDS
AWARD
HELP
Karimangalam________
District coordinator — RDS
Jakkasamudran
Hanumanthapuram
Periyampatti
RDS_______
DHARMAAS
Arokiyam
26 |
ag~
At Block level in concern with Nallampalli Block the following village have selected for the
process.
S.No
Block
1 A nnanagar
Kottapatti
1
NGO
Villages
PHC
2.Sooranatham
CRDS ( Block Nodal
organization)
3. Motur
4. sittilingi
5. Valanoor
1 .Kongam
Koothadipatti
2.
HELP
2.Bharathipuram
B.Mathiyampatti
C5
4 .Thamaraikoliy ampatti
5.Vadugapatti
Chinnakuppam
1. Vachayathi
AWARD
2. P.Kokkarapatti
S.Pattavarthi
4. Chinnakuppam
5. Nambipatti.
And shared that the formation of different committees at different level to monitor the health
activities in the district. he stressed more on the committee formation and its importance in
strengthening the democratic process and it should be ..bottom up representation.
Mr. Sivakuamar:
He took the topic on roles and responsibilities of PHCs and HSCs , he listed out the activities
are being carried out in PHCs and HSCs. The major activities are ..
M.0- PHC:
8 .00am to 11 .00 am op
12 .00 am special cases
5.00 pm field visit one HSC
Dr. Availability Board disply
Attend call duty
Ensure safe drinking water
Endemic Diseases care (If occur )
27 |
Patient welfare society Monitoring
VHSC monitoring
Untied funds monitoring
Birth verification
Free birth certificate issue immediately before discharge from delivery'.
Friday IEC
Trainings to Community health Volunteers
Lab function
Drug supply monitoring and intend.
24 hrs delivery
3SN
And other duties call by the district administration.
VHN- HSC :
8.00 am to 1.00 pm Field visit
1.00 to 3.00 pm rest
3.00 to 5.00 pm records maintain
Prepare FTP ( Field Tour programme )
ATP ( Action Tour Programme )
Monday- AN Day
Tues Day- PHC review
Wednesday- Immunisation
Thrusday- School health
Friday- IEC
Saturday- drop out day
Govt. Schemes ( Muthulakshmi Reddy Scheme and Govt.
Mr. Selvaraj :
Summerised the whole event and proposed to form a committee at the block level. WTith
an opinion of the participants the following members were suggested by the group to
lobby with Block administration. And decided to form a committee with the consent of
all the stake holders in the PHC/Block. Initiate the process of generate awareness in the
identified villages and choose members for forming village level committee to strengthen
the process. He briefed the day long programme and thanked all the participants ,the
state nodal and facilitating organization for provided an opportumtu to initiate the process
in the district.
28 |
a- e
DHARMAPURI DISTRICT - KARIYAMANGALAM BLOCK
Venue : Panchayat Union Meeting Hall, Karimangalam
Time : 10.30 am
Date: 28.12.2007
Attendees :
Participants from NGO Leader, Civil society members, Panchayt Representatives,Govt.
officials (List Enclosed)
Guest:
Ms.RC.R Chandirika Manoharan -chairman-Karimangalam Panchayat Union .
Resource Persons :
Mr.K.Kamalakkannan- Dt. Prog. Co or -CM process
Mr. Elavarasan - director - Arogiyam Trust.
Mr. Vel Murugan-Director - Dharmaas.
Total Participants : 55 Members .
Agenda :
1 .Inauguration
2. Health as Rights an over view
3. Introduction of NRHM & CM
4. Roles & responsibilities of Govt.
5. Health Status in Dharmapuri dt.
6. Formation of Dt. Committee
7. plan of Action .
Tool used :
Training Materials (scribbling Pad, pen , File , Phamplet)
Thematic address
Experience sharing
Group process
Group presentation.
Methodolgy used :
•
Participatory Process followed.
32 |
Report:
The workshop began with welcome address by Mr. Dharmaplingam , Director ,
Kadathur.
RDS-
Ms.BCR.Chandrika Manoharan:
The Chairman - karimangalam Panchayat Union Member presided over the event and
delivered a guest lecture and stated that this is a new programme all the stakeholders should
be participated to make it success. The Panchayt Administration is willing to extend its
support for the success of the process and assures you that what ever the support required let
me committed to do for the cause.
Mr. Kamalakkannan:
District programme co ordinator for CM process ,narrated the whole process being
developed by the Govt, of India and the roles and responsibilities of the state health
department. The basic inputs by him helped the participants to involve in the workshop and
contributed to strengthen the process.
After an inaugural function , thrust area of the workshop focused elaborately. An hour
Thematic speech on health as right sensitized the participants to re act in the process. Every
body felt that this is very much important and monitor the health activities in the area and
very clearly shared that the CM process doesn’t mean to find fault against the system but
strengthen the system to make it reality by reach out to entire community.
He also narrated the CM process in the district and the list of blocks, PHCs and coordinating
NGOs in which the pilot phase of community monitoring is to be undertaken was finalised as
follows.
Block
PHC
Coordinating
NGO
Nallampalli
Indur
SEVA
District coordinator - SEEDS
Thoppur
Pothigai
Palayanpudur
SEEDS
Harur
Kotapatti
CRDS
District coordinator - CRDS
Chinnakuppam
AWARD
Koothadipatti
HELP
Karimangalam
Jakkasamudran
RDS
District coordinator - RDS
Hanumanthapuram
DHARMAAS
Periyampatti
Arokiyam
33 | P ~
At Block level in concern with Nallampalli Block the following village have selected for the
process.
Block
S.No
1
Villages
PHC
Karimangaiam Jakkasamudram
1 .Soddapatti
2.Bikkanahalii
NGO
RDS ( Block Nodal
NGO)
S.Veersoonur
4. Bhoothipatti
5.Seengari
2.
Hanumanthapuram
1 .Sonnampatti
DHARMAAS
2.vaiyalkottai
3 .Mathanerikottai
4.Sottanampati
5. savadiyur
Periyampatti
1 .Modhur
Arogiyam Trust.
2.Kamalapuram
S.Ramiyanahalli
4. Medunahalli
5. Nimangarai&
colony.
And shared that the formation of different committees at different level to monitor the health
activities in the district, he stressed more on the committee formation and its importance in
strengthening the democratic process and it should be ..bottom up representation.
Mr. Elavarasan:
He took the topic on roles and responsibilities of PHCs and HSCs , he listed out the activities
are being carried out in PHCs and HSCs. The major activities are ..
M.O- PHC:
8 .00am to 11 .00 am op
12 .00 am special cases
5.00 pm field visit one HSC
Dr. Availability Board disply
Attend call duty
Ensure safe drinking water
Endemic Diseases care (If occur )
Patient welfare society Monitoring
34 |
VHSC monitoring
Untied funds monitoring
Birth verification
Free birth certificate issue immediately before discharge from delivery.
Friday IEC
Trainings to Community health Volunteers
Lab function
Drug supply monitoring and intend.
24 hrs delivery
3SN
And other duties call by the district administration.
VHN- HSC :
•
8.00 am to 1.00 pm Field visit
•
1.00 to 3.00 pm rest
•
3.00 to 5.00 pm records maintain
•
Prepare FTP (Field Tour programme)
•
ATP (Action Tour Programme )
•
Monday- AN Day
•
Tues Day- PHC review
•
Wednesday- Immunisation
•
Thrusday- School health
•
Friday- IEC
•
Saturday- drop out day
•
Govt. Schemes (Muthulakshmi Reddy Scheme and Govt.
Mr. Velmurugan :
Summerised the whole event and proposed to form a committee at the block level. With an
opinion of the participants the following members were suggested by the group to lobby with
Block administration. And decided to form a committee with the consent of all the stake
holders in the PHC/Block . Initiate the process of generate awareness in the identified
villages and choose members for forming village level committee to strengthen the process.
Mr. Kanniyan :
He briefed the day long programme and thanked all the participants .the state nodal and
facilitating organization for provided an opportunitu to initiate the process in the district
a
35 | P a < e
Name
Address
1
S.Maghalakshmi
2
R.Ananthanayaki
3
P.Ganthiniathi
Magenthiramangalan} (HSC)
Jakkasamuthiram (PHC)________
Thumbalahalli (HSC)
Anumanthapuram (PHC)________
Anumanthapuram (HSC&PHC)
4
R.Kanivaani
5
V.Devaki
6
S.Mageshvari
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
A. Rema________________
M.Manjsula_____________
Samakkal______________
Inthira_________________
S.Vanithameri___________
V.Kokkila______________
Murugammal___________
Sivasangkari____________
Kavitha________________
Chennammal
M.Santhira_____________
M^Meenashi____________
M. Parvathi W/o Murugesan
S. B.Murugesan__________
T. Muniraj______________
B. Dhanalakshmi_________
A.Amsaveni____________
N. Arputham_______
Mniyammal____________
V.Bhaskar______________
S.Sakthivelli____________
S. Kavitha______________
M.Ubakarameri_________
T. Saravanan____________
G.Thirupathi____________
P.Krishnamurthi_________
E.P.Kavitha____________
S.Komathi_____________
G.Suguna______________
M.Maghenthiravarma
K.Ramalingam__________
Selvam________________
M. Muniyan_____________
R.Govindharaj__________
N. Yvarasan____________
K.Murthi
S.NO
Pommahalii(HSC)
Anumanthapuram(PHC)________
Kottavur (HSC)
AnumanthapuramfPHC)________
Bikkanahalli(HSC)
Jakkasamuthiram(PHC)_________
Magenthiramangalam (PO)______
Magenthiramangalam (PO)______
Ward Member, Bikkanahalli_____
Bikkanahalli Maghalakshmi(SHG)
Savadiur____________________
Malliguddai (PO)______________
Malliguddai (PO)______________
Anumanthapuram_____________
Anumanthapuram_____________
Anumanthapuram_____________
Magenthiramangalam (PO)______
Sottanahalli__________________
Anumanthapuram_____________
Sottanahalli__________________
Anumanthapuram_____________
Malliguddai (PO)_____________
Modur(PO)__________________
Modur (PO)__________________
Podigai SGH, Sudappatti_______
Anumanthapuram(President)
Magenthiramangalam (PO)______
Magenthiramangalam (PO)______
Savadiur____________________
Magenthiramangalam (PO)______
Magenthiramangalam (PO)______
Magenthiramangalam (PO)______
Anumanthapuram_____________
Anumanthapuram_____________
Anumanthapuram_____________
Dr.Annaipesan NGO, Palacode
RDS NGO, Seengeri___________
RDS NGQ, Seengeri___________
RDS NGO, Seengeri___________
RDS NGO, Bikkanahalli________
Bkkanahaili__________________
RDS
36 | P a g e
43
44
45
46
47
48
49
50
51
52
53
54
55
B. C. R. C hanthirikamanokaran
R.Saravanan_____________
M. Ganesan______________
G.V.Uthayasanker_________
R.M.Sanmugam__________
K.Murugammal___________
P. Prakash________________
V.Saratha_______________
P.S.Velmurugan__________
K.Kannaiyan_____________
G.Surilirajan_____________
N. Kamalakkannan________
R,Dharmalingam
Councilor. Karimangkalam___________
Anumanthapuram__________________
Periyampatti______________________
Karimangalam_____________________
President. Malliguddaihalli___________
Poomandahalli____________________
Bikkanahalli______________________
Bikkanahalli______________________
Director. DHAJ<MAAS. NGQ. Palacode
DHARMAAS, NGO. Palacode_______
DHARMAAS. NGQ. Palacode_______
NRHM. (Dt). CO-oridenet____________
Director. R.D.S, NGO. Kadathur
Karimangalam Block - Panchayat Villages
Number of Panchayat Villages
Annamalaihalli
Adilam
Bandarahalli
Bommahalli
Gendiganahalli
Kumbarahalli
Mottulu
Naganampatti
Pummandahalli
Baisuhalli
Begarahalli■ Bikkanahalli
Erraseegalahalli
Flumichanahalli
Hanumanthapuram Indamangalam
Jakkasamuthiram Jittandahalli
Karakodahalli
3®
Kalappanahalli
Kovilur
Kattenahalli
Mahendnimangalam Mallikuttai
Murukampatti
Mukulum
Periyampatti
Thindal
Pulikkal_____
Thumbalahalli
37 | P a g e
DHARMAPURI DISTRICT - NALLAMPALLI BLOCK
Venue : Panchayat Union Meeting Hall, Nallampalli.
Date: 28.12.2007
Time: 10.30 am
Attendees :
Mr.K.P.Senthilraja- Peoples watch- Dharmapuri.
Mr.saravanan-Director-SEEDS-Nallampalli
Mr. Velmurugan-Director- Dharmaas-Palacode.
Participants from NGO Leader, Civil society members, Panchayt Representatives,Govt.
officials (List Enclosed)
Guest:
1. Mr.Subramani - Chairman , Nallampalli Panchayt Union.
2. Ms.Vijayakumari, BDO - Nallampalli
3. Ms.Sampath kumari- SHN.Palayampudur.
Resource Persons:
Mr.M.Shankar-president-DHVANI (Dt. Nodal Orgn.)
Mr.K.Kamalakkannan, Dt.prog.Co or -CM process -DHVANI.
Mr.Senthil Raja - Human Rights Activist- Dharmapuri.
Total Participants : 60 Members .
Agenda :
1 .Inauguration
2. Health as Rights an over view
3. Introduction ofNRHM & CM
4. Roles & responsibilities of Govt.
5. Health Status in Dharmapuri dt.
6. Formation of Dt. Committee
7. plan of Action .
Tool used :
a. Training Materials ( scribbling Pad, pen , File , Phamplet)
b. Thematic address
c. Experience sharing
d. Group process
38 |
a
-r
e. Group presentation.
Methodolgy used :
1. Participatory Process followed.
Report:
The workshop began with welcome address by Mr.Saravanan. Director, SEEDS Nallampalli.
Mr. M.Shankar. President - DHVANI, delivered an introductory' address on NRHM and CM
process and also briefed on the importance of workshop. In his address stated that NRHM is
an initiative by the Govt, of India to ensure health to all before 2012. The major thrust of the
programme is to reach the un reached in society.
Mr. Subramani:
The Panchayat Chairman delivered a guest lecture and stated that this is a new programme
all the stakeholders should be participated to make it success. The Panchayt Administration
is willing to extend its support for the success of the process and assures you that what ever
the support required let me committed to do for the cause.
Mr. Kamalakannan
District programme co ordinator for CM process ,narrated the whole process being
developed by the Govt, of India and the roles and responsibilities of the state health
department. The basic inputs by him helped the participants to involve in the workshop and
contributed to strengthen the process.
After an inaugural function , thrust area of the workshop focused by Mr. Shankar elaborately.
An hour Thematic speech on health as right sensitized the participants to re act in the process.
Every7 body felt that this is very much important and monitor the health activities in the area
and very clearly shared that the CM process doesn’t mean to find fault against the system but
strengthen the system to make it reality by reach out to entire community.
He also narrated the CM process in the district and the list of blocks, PHCs and coordinating
NGOs in which the pilot phase of community monitoring is to be undertaken was finalised as
follows.
PHC
Indur_______
Thoppur
Palayanpudur
Coordinating NGO
Harur_________________
District coordinator - CRDS
Kotapatti_____
Chinnakuppam
Koothadipatti
CRDS
AWARD
HELP
Karimangalam_________
District coordinator - RDS
Jakkasamudran
Hanumanthapuram
Periyampatti
RDS_______
DHARMAAS
Arokiyam
Block
Nallampalli______________
District coordinator - SEEDS
SEVA
Pothigai__________
SEEDS
39 |
At Block level in concern with Nallampalli Block the following village have selected for the
process .
S.No
Block
1. Palayampudur
Palayampudur
1
NGO
Villages
PHC
2. Thombarakampatti
Nodal
SEED(Block
NGO)
3 .Thandukaranpatti
Pagalahalli
Kandukalpatti
Thoppur
2.
1 .Thoppur
Pothigai
2. T.Kanikarahalli
C5
Q.
E
3. Paapireddiyur
4. Esalpatti
z
5. Jarugu
Indur
3.
1 .Pommasamudram
SEVA
2.Palavadi
Koorampatti
4.Nagalapuram
5.Sirugalur
And shared that the formation of different committees at different level to monitor the health
activities in the district. he stressed more on the committee formation and its importance in
strengthening the democratic process and it should be ..bottom up representation.
Mr.Kamalakannan :
He took the topic on roles and responsibilities of PHCs and HSCs , he listed out the activities
are being carried out in PHCs and HSCs. The major activities are ..
M.O- PHC:
a. 00am to 11 .00 am op
b. 12 .00 am special cases
c. 5.00 pm field visit one HSC
d. Dr. Availability Board disply
e. Attend call dutv
f. Ensure safe drinking water
g. Endemic Diseases care (If occur)
h. Patient welfare society Monitoring
40 |
i. VHSC monitoring
j.
Untied funds monitoring
k. Birth verification
1.
Free birth certificate issue immediately before discharge from delivery'.
m. Friday IEC
n. Trainings to Community health Volunteers
o. Lab function
p. Drug supply monitoring and intend.
q. 24 hrs delivery
r. 3SN
s. And other duties call by the district administration.
VHN- HSC :
a. 8.00 am to 1.00 pm Field visit
b. 1.00 to 3.00 pm rest
c. 3.00 to 5.00 pm records maintain
d. Prepare FTP ( Field Tour programme )
e. ATP ( Action Tour Programme)
f. Monday- AN Day
g. Tues Day- PHC review
h. Wednesday- Immunisation
i.
Thrusday- School health
j.
Friday- IEC
k. Saturday- drop out day
l.
Govt. Schemes (Muthulakshmi Reddy Scheme and Govt.
Mr. Sentil Raja:
He developed the process to be carried out at various level. Summerised the whole event and
proposed to form a committee at the block level. With an opinion of the participants the
following members were suggested by the group to lobby with Block administration. And
decided to form a committee with the consent of all the stake holders in the PHC/Block.
Initiate the process of generate awareness in the identified villages and choose members for
forming village level committee to strengthen the process.
Mr. Durai mani :
He briefed the day long programme and thanked all the participants ,the state nodal and
facilitating organization for provided an opportunitu to initiate the process in the district.
41 |
39
40”
4?
42”
43"
44"
4?
46’
47
IT
49
To"
■52
~53
’54
~55
~56
"57
58
“59
60
Chinnasami
T. Ganakamthavas i
Tamilselvi
Malliga
Muniyammal
Sumathi
C.Kandasami
M.Theepa
M.Shanker
S. Amalapan
K.Karpakavalli
A. Rani
K.Madhayan
P.Theivanai
M.Maghenthiran
P.Subramani
T. V.Rajendhiran
M.Vijayakumari
R.Dhayalan
A.Saravanan
V .Ramachanthiran
Bagalpatti
PNMN
Kullampatti________________
Kullampatti
Koorampatti
Koorampatti
Palayamapudhur
Thoppur
Dr.DHVANI
Thoppur
VHN, Maniyakaranur
VHN. Jarugu
Union Co-ordinate, Valarkalvi.
Village Nurse, Melselpatti.
Echampatti
Chairman, Nallampalli.
BDO, Nallampalli.
Commissioner,
President, Thoppur.
SEEDS, Nallampalli.
Assist. Panchayat, Nallampalli.
Nallampalli Block - Panchayat Villages
Number of Panchayat Villages|
32
Adiyamankottai
A.jettihalli
Bandahalli
Bedarahalli
Dhalavaihalli
Budrahalli
Dokkubodhanahalli Echanahalli
Balajangamanahalli
Bommesamuthiram
Dhinnahalli
Elagiri
Kommampatti
Errabaiyanahalli
Indur
Konangihalli
Mademangalam
Laligam___
Mittareddihalli Nagarkoodal
Maniyathahalli
Nallampalli
Palavadi
Samichettipatti
Thadangam
Narthampatti Pagalahalli
Palayampudur Pengunatham
Sivadi
Somenahalli
Thoppur
43 | P a g e
KANYAKUMARI DISTRICT WORKSHOP-TOT REPORT
Venue: Pioneer paradise. NagercoiL
Date: 13/12/2007
Time: 10. A.M
Attendees:
1.
Fr.Joseph Justus -VHAK(President)
2.
Mrs. Jennet-VHN(State Vice President)
3.
Dr.N.V Suganthan-
4.
Fr.Edvin -NCN
5.
Xavior Lawemce -NCN
6.
Jaykumar - Malar
7.
Mrs.Parvathi - Malar
8.
M.Philo John -Negle Health Center -Kodimunai
9.
Parkavi -Negle Health Centre -Colachai
10.
Chithra-VHAK full timer -siman colony
11.
FrJoseph Justus -VHAK(President)
12.
Mrs. Jennet-VHN(State Vice President)
13.
Dr.N.V Suganthan-
14.
Fr.Edvin -NCN
15.
Xavior Lawemce -NCN
16.
Jaykumar - Malar
17.
Mrs.Parvathi - Malar
18.
M.Philo John -Negle Health Center -Kodimunai
19.
Parkavi -Negle Health Centre -Colachai
20.
Chithra-VHAK full timer -siman colony
21.
Prema ravintharan -Malar -nagercoil
22.
Sasikumar -TNSF -
23.
Chandrakalla-malar -kutiparavillai
24.
Geethamary -Malar-paramankootam
25.
Rajamanikam -Malar-velliyampallam
26.
Jeemila-vhak full timer -ravilli
27.
Muparag VHAK SCF Project Organizer-Edalakudi
28.
Lawrence-vhak-Kurumpannai
44 |
29.
Mary shalima- vhak Full timer -Kurumpannai
30.
V.S.Antony -VHAK Full timer-kurumbanai
31.
R.Vimal-VHAK SCF Project Organizer -Nagercoil
32.
N Rathika -vhak SCF Project Organizer-Parakai
33.
F.Ntchathiram-vhak Full timer-Kovalam
34.
Rajan-vhak Full timer-kanyakumari
35.
Shibana-vhak Full timer-puthukiramam
36.
Premila-Vhak Full timer-puthugramam
37.
Raj ini-vhak Full timer-puthugiramam
38.
Jeyammal-vhak Full timer-kandan villai
39.
Leemarose-vhak Full timer-velliyavillai
40.
Bemad Every Child Coordinator -Rajakamangalam
41.
Hafeezh SCF Project Organizer-Edalakudi
42.
Sharmila-VHak Full timer-puthugramam
43.
Anitha-vhak Full timer-Nagercoil
44.
Sheela-vhak-Kollanchi
45.
Mariyanantham-vhak-Kandanvillai
46.
Rosely -malar-Aralvaimoli
47.
Hilda-vhak-Kulasegaram
48.
Nirmala-vhak-Manavillai
49.
Catherin-Negle Health Centre-Vanniyakudi
50.
jeya-Negle Health Centre-Vaniyakudi
51.
Little Flower-Vhak-Eranial
52.
Komala-CHAT-Ganapattu puram
53.
N.Vini-Malar-kaliancodu
54.
Viji-Malar-Kaliyancodu
55.
Daisy-Vhak-Kurusadi
56.
Juliet-vhak-Kovilvillai
57.
Bibinal-vhak-Palliyadi
58.
Vaj ila-vhak-Puthukadai
59.
Bino-vhak-V avathurai
60.
Ratha-vhak SCF Project Organizer-South puthalam
61.
Vini-vhak-Elluvillai
62.
Latha-malar-Thengamputhoor
63.
F athima-malar-Enayam
45 |
64.
Kishore kumar—
65.
jegen
66.
Mercy-puthenturai
67.
Vishalashi- NRHM (Block Coordinator )-kurunthancodu
68.
S.M Rexaline - NRHM (Block Coordinator )-nagercoil
69.
Saroja- NRHM (Block Coordinator )-killiyoor
70.
S. Deepa-NRHM (District Coordinator)-kanyakumari.
Guest:
Fr. Edwin -NON President
Resource Persons:
■
Mrs. Jennet
Agenda:
TIME
10.00a.m
10.30a.m
SECTION
Registration_____
Welcome Address
10.40a.m
NRHM - Introduction
11 .OOa.m
11.30a.m
Tea Break___________________
Roles and responsibility of PHC, SC,
CHC and VHN_________________
Lunch Break___________________
Group Discussion
1 .OOp.m
Post Lunch
RESOURCE PERSON
Miss. Deepa (kanyakumari District
Coordinator NRHM)___________
Fr. Joseph Justus(Mentoring
committee Member)
Jennet VHN (State Vice -President)
Fr. Joseph Justus
Report:
Section: 1
Registration carried out Mrs. Vishalashi VHAK(NRHM Block Coordinator )
o
Total participation member is 60
o
Resource Person 1
o
Guest 1
The Meeting was started with concise of welcome address by S. Sahaya Deepa ,
(NRHM) Kanyakumari District Coordinator
> NRHM -Introduction part did by Rev Fr. Joseph Justus, president VHAK. He
explained the project Details and the Activities, specially explained about the G.O
> The meeting picks up where you left off after a small tea break.
> Mrs. Jennet (VHN)-Vice President was the recourse person of the program
• Mrs. Jennet briefly explained the VHN roles and responsibilities
• what are the problems faced by VHN
• What are the facilities available for the Sub center, CHC and PHC
>
46 |
•
Gave the clarification about the SC, PHC, and CHC.
> Lunch Break
> Afternoon section was facilitated by Rev Fr.Joseph Justus. The following details
were discussed during group discussion
■ Selection of Village
■ How to implement this pilot project in the Block level
■ What are the strategies used for the committee formation
■ Suggested the Block level Meeting Date and place
■ Noted the availability of the Resource persons
Date_____Place_____________
' 19/12/2007
YMCA Kanyakumari
' 20/12/2007
Pioneer paradise
Nagercoil
21/12/2007
Block Name
Agestheeswaram
Killiyoor
Kurunthancodu
The following names were suggested for the District Mentoring Committee
Fr. Joseph Justus -President of VHAK
Dr. Gracia -Nagel Director
Dr. Shoben raj -President of Short College
Dr. Jeser Jebenaser -President of science forum
Mr. Thomas Franco -Malar
Mr. Pushparaj-VHAK Secretary
S Mr. Thomas -Consumer protection Councilor
Mr. Sasikumar-Science Forum
J Fr. Dominic-Xavier’s Catholic Nursing College Corresponded
Fr. Edwin-NCN
Sr. Rose-CHAT
Fr. Johnsonraj.
> Finally Mrs. Rexaline VHAK (NRHM Block Coordinator )Collect the Feedback
> The meeting ends with a vote of thanks by Mrs. Saroja Science forum (NRHMBlock Coordinator)
S
J
J
J
47 |
Kanniyakumari District
Blocks
Th iru vat-tar
Thouala
Thackalai
Kurunthancode
tiswaram
(Map Not to Scale)
Digital Map Source : TWAD Board, Chennai
Web Design : NIC, TNSC
We Chose the Blocks are
Number of Panchayat Villages
99
(Select any Block
Ift Panchayat
Panchayat
Block
Block
Villages
__ ______ _ Villages
8~
Killiyoor
isAgastiswaram
Kurunthancode
9
48 | P a g e
KANYAKUMARI DISTRICT - AGASTHEESWARAM BLOCK
Venue: Thollamai illam, Kovalam , Kanyakumari
Date: 20/12/2007
Time: 10.00 am to 5.00
Guest:
•
Fr. Joseph Justus (VHAK President)Mentoring Committee Member
•
Dr. Shobana Raj (Mentoring Committee Member)
Resource Persons:
a. Mrs. Dr. Christy (Government Hospital Doctor )Kanyakumari
District
b. Kir. Thanga sivam (Health Inspector)Kanyakumari District
Attendees:
1. S. Sahaya Deepa (District coordinator )
2. S. Rexselin( Block Coordinator )
3. Beula (Dr. Kumara swami Nursing Center School)
4. V. Saraniya (Dr. Kumara swami Nursing Center School)
5. N. Seethakumari (Dr. Kumara swami Nursing Center School)
6. T. Muthulekshmi (HOM Volunteers)
7. T.Ramani(Dr. Kumara swami Nursing Center School)
8. N. Vijayaleshmi(Dr. Kumara swami Nursing Center School)
9. P.Palkani(Dr. Kumara swami Nursing Center School)
10. M.Manjusha (Dr. Kumara swami Nursing Center School)
11. J. Merlin Shoba (Dr. Kumara swami Nursing Center School)
12. G. Anitha (Dr. Kumara swami Nursing Center School)
13. S. Kavitha (Dr. Kumara swami Nursing Center School)
14. K. Sutha (Dr. Kumara swami Nursing Center School)
15. M.Selva shaline (Dr. Kumara swami Nursing Center School)
16. K.Sumathi (Dr. Kumara swami Nursing Center School)
17. Y.Akila (Dr. Kumara swami Nursing Center School)
18. N.Rathika (VHAK Organizer )
19. A. Sahaya Pino (VHAK Animator )
20. C.Ratha (VHAK Animator)
21. A.M Rajen (VHAK Animator )
22. A.Vini (VHAK Animator)
49 |
23. K.Rajini (VHAK Animator)
24. J.Mary sahaya Shipana (VHAK Animator)
25. S.Mary Pramila (VHAK Animator)
26. F. Natchathiram (VHAK Animator)
27. P.L Kavitha sree (VHAK Animator )
28. R.Kishore Kumar (VHAK Animator )
29. T.R Jegen(Govemment Hospital Counselor) Kanyakumari
30. J.Lenin Joseph (Government Hospital Counselor) Kanyakumari
31. T.Yesu Anbu Latha (Government Hospital Counselor) Kanyakumari
32. S.Bijrul Hafeezh (VHAK Organizer)
33. S.Anusha Mary (VHAK Animator)
34. A.Xavier (VHAK Animator)
35. R.Sharmila (VHAK Animator)
36. A. Vijaya Lekshmi(VHAK Animator)
37. L.Glori Bai (VHAK Animator)
38. R.Mallika (VHAK Animator)
39. A.M sahila (VHAK Animator)
40. C. Sareswathi (VHAK Animator)
Programme Schedule:
TIME
10.00 a.m
10.30 a.m
SECTION
Registration_____
Welcome Address
10.40 a.m
11.30 a.m
03.00 p.m
NRHM Introduction
Power point
presentation - Health
and sanitation, NRHM
Monitoring__________
Explaination about
medical institution
facilities____________
Roles and duties of
PHC & HSC Doctors,
Nurse, VHN and Health
inspector____________
Group Discussion
04.30 p.m
Vote of thanks
02.00 p.m
03-00 p.m
RESOURCE PERSON_____________________
Mrs. Rexselin (Block coordinator )____________
Miss. Deepa (Kanyakumari District Coordinator
NRHM)_________________________________
Fr. Joseph Justus (Mentoring committee Member)
Dr. Shobana Raj Mentoring Committee Member
Dr. Christy (Kanyakumari G.H Doctor)
Mr. Kanthasivam (Health inspector,
Agestheeswarm)
Fr. JosephJustus (VHAK President) Mentoring team
member___________________________________
Mrs. Rexselin
50 | P 3
Report:
Session:!
•
Registration carried
Coordinator )
out by
Mrs.
Rexalin VHAK(NRHM
Block
o Total number of participation is 39
o Resource Person- 2
o Guest -2
•
Welcome Speech -Miss. Deepa, Kanyakumari District CoordinatorNRHM project welcomed the participants as well as Fr. Joseph Justus,
President-VHAK, one of the mentoring committee members Dr. Christy,
doctor in Kanyakumari G.H, Mr. Kantha Swami, Health Inspector in
Kanyakumari and Dr. Shobana Raj, mentoring team member.
Introduction of NRHM: This session is carried out by Rev Fr. Joseph Justus
(VHAK President). He explained that National Rural Health Mission is a pilot
project Government may provide medical aid for the rural area poor people.
Through Government Hospital Primary Health Center and Health Sub Centers,
and it wants to mom for weather this aid really reaches the right people.For that
the Government selected five states. TamilNadu is one of the states. In
TamilNadu five Districts are selected to monitor the Government Medical
Institutions.
NRHM Project, pave ways to analyze and monitor the community and medical
institutions. NRHM project analyzed the reasons why the people are not using the
facilities offered by the Government Medical institutions. Kanyakumari District
carried out this analysis in a different manner. First it creates awareness to the
people and explains to them the Government Schemes and its benefits to the
people. Then it makes the people to visit and monitor the Government medical
institutions. NRHM Project gives awareness to the grassroots level people also to
monitor the government aided activities.
The project concept is not to blame anybody or to find the causes for the failure of
the Government institutions. The only aim is to ensure that the Government
medical schemes reach the rural people through Government medical institutions.
Expectation of NRHM Project
To eradicate the Infant Mortality
J To eradicate the Infant Mother’s Mortality'
To remove the hindrance and ensuring Basic facilities to the rural
people welfare
J To eradicate open toilet system
To eradicate Communicable Diseases
S To accomplish basic Facilities to the G.H, PHC, and HSC.
51 |
1U 4 9 3
Dr. Shobana Raj Speech :
Dr. Shobana Raj who was in TamilNadu Science forum NRHM said that this
Project ensures and monitors facilities and benefits which are available to the
rural area people through Medical Institutions.
As per “WHO” said that The Human beings must have enough food,
protected water, education, awareness of environment, Health and sanitary
facilities. He said the rural people even now follow traditional medicines. The
Government hospitals PHC and HSC are promoted for the rural area people but
the rural area people not using this kind of facilities due to lack of basic facilities
and care to the patients in Government hospitals.
The total population of Kanyakumari is about 17 lakhs. In 2010 the population
may increased to 20Lakhs. So the PHC and HSC have great role in the health
sector.
Kanyakumari we have 34PHC, and 237HSC Village Health Nurses.
For every 5,000 People there is one VHN. 60% the people are going to private
Health centre. In every PHC we have 3 Doctors, 3 Pediatrician, 6Nurses and 2
Para medicals. The Health sub center must provide basic Facilities to the VHN
to stay in the Centre.
Session carried out by Dr. Christy, Medical officer in Kanyakumari G.H. She
explained the Roles and duties of the government medical institution.
J The duties of the PHC,HSC and G.H is to prevent the diseases
J To encourage Family Planning.
J To ensure Every Wednesday check up for the pregnant ladies by the
Doctor.
To ensure the Medical officer is available doing their tour of duties and
also to see that the specialists for various diseases are on duty during
the stipulated days and timing.
Roles and Duties of Primary Health Center -Mr. Kanthasivam (Health inspector):
Mr. Kanthasivam was Health inspector of Agestheeswaram block, there are
3Health inspectors.
X The duties of HSC is to prevent diseases
X To Create Awareness among People to Control the Communicable
Diseases
X Check water and sanitation of the village
X Check the water for contamination and ensure protected water in
supplied.
52 I
4- To Destroy the flies and Mosquito
-I- Check Aganwadi Centre
4- To ensure the Aganwadi Workers if she gave Health food to the Children
-I- To immediate action on default workers under "Health Act”
4- To Awareness and ensuring of immunization for the new bom child.
4- Providing Health Tablet’s to the community
4- Providing plus Polio Medicine ,file area tablet etc...to control the
diseases
Group Discussion -Fr. Joseph Justus:
The participants were divided in to four Groups who ensure and monitor
Kanyakumari G.H, Azhappapuram, Kottaram and agestheeswaram.
•
•
•
•
Kanyakumari G.H
Agastheeswaram Block has 5 villages
Azhappapuram has 4 villages
Kottaram has 6 villages
The Participants were divided in to the above classification and they planned to
monitor the G.H, PHC and HSC
These groups collected the statistical data of the village, VHN name and mobile
number, Health and sanitation committee members, patient Welfare Committee
Members and important persons of the villages.
The Monitoring programme will start at the end of January 2008 or at the
beginning of February 2008.
Vote of thanks - Mrs. Rexselin :
Mrs. Rexselin Block coordinator of NRHM project thanked Rev Fr. Joseph Justus,
Dr. Shobana Raj, Dr. Christy, Mr.Kanthasivam and all the participants.
Feed back
Most of them said their project is a gift for them. Through this project the people
will come to know about the facilities of HSC, PHC and G.H. They learned the
role and duties of PHC, HSC and G.H. They have shown interest to ensure and
monitor the government medical institutions. It helps them to gather knowledge
about roles and duties of health inspector, VHN and doctor.
53 |
KANYAKUMARI DISTRICT - KILLIYUR BLOCK
Venue:
Hotel Jalal, Karungal.
Date:
19/12/2007
Time: 10.00 am to 5.00
Resource Persons:
1. Fr. Joseph Justus President -VHAK (Mentoring Committee
Member)
2. Mr. Jeyakumar(Science Forum president -Killiyoor Block)
3. Mr. Sasi Kumar (District Secretary ,Science Forum)
4. Gino Bai ( Panchayat President, Midalam)
5. Mrs.S.Jennet Bai (State Vice President ,TN)
Guest:
a. Mrs. John sly Bai (Secretary- Malar)
b. Mr. Raja Manikam (State Mentoring Committee,TNSF)
Attendees :
1. S. Sahaya Deepa (District coordinator)
2. Mrs. Saroja (Killiyoor Block Coordinator Science Forum)
3. s. Rosely (malar)kattu villai ,Nattalam Post
4. M.Rajakumari (Malar) keezhvillai ,Nattalam Post
5. R.Dheepa (Malar) Keezh villai ,Nattalam Post
6. V.Dani Glory Bai (Malar) Nattalam Post
7. Java (Panamkuzhvillai)
8. P.serin (VHAK)Melmidalam
9. A.Vajila(VHAK)Putthukadai
10. V.Jennet Hillda (VHAK) Kulasekaram
11. A.Mary Bibinal (VHAK) Puthukadai
12. Thangam(TNSF) Paraman Konam
13. Vini(TNSF) Theruvukadai
14. Viji, Malar group Secretary,Theruvukkadu
15. S.Reena(Puttati)
16. G.Santhi(Malar) Theruvukkadai
17. K.Usha (Malar) Theruvukkadai
54 | P 5 F. ?
18. A.Geetha Mary (Paraman Konam)
19. N.Chandra sekar (TNSF)
20. Rajakumari (TNSF)
21. Rani (Malar)
22. Selva Chandra(TNSF)
23. T.Sutha Mary(Malar)
24. S.Loosee(TNSF)
25. Kala(Malar)
26. N.Ramakumari(TNSF)
27. P.Chandra(TNSF) Kannavillai Uthayamarthandam post
28. P.Clio (VHAK) Kurumpannai post
29. S.Anitha(TNSF)Kannavillai uthayamarthandam post
30. T.Parvathi(TNSF)Midalam
31. Mabel (VHAK)Midalam
32. V.Prema (TNSF)Karungal Post
33. R.Pushpalatha(TNSF)Keelkulam post
34. R.Glory(TNSF)Karungal post
35. Paul thangam(TNSF)Vengavilal
36. Mr.SasiKmar(TNSF)Mentoring Team member
37. Saveriyammal(VHAK)Melmiddalam
38. Johnsily Bai(Malar) Secretry
39. Rajappan(TNSF)
40. Jeyalatha(Malar) Viricodu
41. M.Fathima(Malar)Enaiyam
42. Latha (Malar)Udaercudi
43. Jenita(Malar)Enaiyam Post
44. Jeyakumar(Oxford)
45. Sabapathi (TNSF)Kannuvilai
46. L.Antony(TNSF)Kannanvillai
47. P.Veelammal(VHAK)Enaiyam
55 ) P a g e
Programme Schedule:
Time
10.30 a.m
11.00 a.m
Session
Registration
Prayer song
11.05 a.m
Welcome Address
11.10a.m
Presidential Address
Resource person______________________
Mrs. Saroja (Block Coordinator )
Science Forum________________________
Mrs.J.Gino Bai, (Secretary TNSF ,Killiyoor
Block)_____ ________________________
Mr.Jeya Kumar,(President TNSF, Killiyoor
Block)
11.15 a.m
Introduction of
NRHM,
Rev Fr. Joseph Justus President -VHAK
11.45 a.m to
01.00 p.m
Community
Monitoring and
Perspectives from
the field
1. Mrs.S.Jennet Bai (State Vice President ,TN)
2. Mr.Arul Raj /Health Inspector)__________
3. Dr.Sivakumar________________________
01.00 p.m to
01.30 p.m
Structure and
Processes of NRHM
Mr. P. Rajamanickam, (Convener State
Mentoring Committee,TNSF)
01.30 p.m to
02.00 p.m
Lunch Break
Post Lunch
Session
Group Discussion
Rev Fr. Joseph Justus (VHAK President)
I 03.00 p.m
Vote of Thanks
Mrs. S. Suseela, (District Coordinator, Arokiyam
sub Committee TNSF.)
Report:
Session: 1
Registration carried out Mrs. Saroja TNSF (NRHM Block Coordinator)
o
Total participation member is 47
o
Resource Person 5
o
Guest 2
Prayer song Participated the Science Forum
Welcome Speech -Mrs. Gino Bai, Secretary of TNSF in Killiyoor Block
Welcomed the participates and also Fr. Joseph Justus Prescient VHAK and the
Mentoring Committee Member, Mr. Jeyakumar (Science Forum Killiyoor Block
President) and Mr. Sasi Kumar (Science Forum District Secretary) as well as Mrs.
Jenni Bai (Medalam Panjoyat President) then Mrs. John sly Bai (Malar Ngo
Secretary).
56)
Introduction of NRHM: This section is carried out by Rev Fr. Joseph Justus
(VHAK President). He explained that National Rural Health Mission is a pilot
project Government may provide medical aid for the rural area poor people.
Through Government Hospital Primary Health Center and Health Sub Centers,
and it wants to mom for weather this aid really reaches the right people.For that
the Government selected five states. TamilNadu is one of the states. In
TamilNadu five Districts are selected to monitor the Government Medical
Institutions.
NRHM Project, pave ways to analyze and monitor the community and medical
institutions. NRHM project analyzed the reasons why the people are not using the
facilities offered by the Government Medical institutions. Kanyakumari District
carried out this analysis in a different manner. First it creates awareness to the
people and explains to them the Government Schemes and its benefits to the
people. Then it makes the people to visit and monitor the Government medical
institutions. NRHM Project gives awareness to the grassroots level people also to
monitor the government aided activities.
The project concept is not to blame anybody or to find the causes for the failure of
the Government institutions. The only aim is to ensure that the Government
medical schemes reach the rural people through Government medical institutions.
Expectation of NRHM Project
To eradicate the Infant Mortality
To eradicate the Infant Mother’s Mortality
To remove the hindrance and ensuring Basic facilities to the rural
people welfare
To eradicate open toilet system
To eradicate Communicable Diseases
To accomplish basic Facilities to the G.H, PHC, and HSC.
Mrs. Jennet Bai, State Vice President VHN Association, TamilNadu distributed a catalog on
the list of the services available at the sub-centers, PHCs and also she explained about the
VHN Roles.
VHN Roles:
❖
Data collection about Village population, pregnancy list, newly married
persons, death and New Birth.
❖ To Regulate the Pregnancy registration
❖ To visit the mother and child thrice in a month immediately after delivery.
❖
Providing Maternal Health, Antenatal care, intranatal care and postnatal care.
57 | P
g
❖ To Give Awareness about the Health and Nutrition, Normal Delivery and
Institutional Delivery
❖ Awareness and ensuring of immunization for the new bom child
❖ D.T.P and Polio Drop
VHN Duty Chart
Monday -Pregnancy Test
Tuesday -Review
Wednesday -Immunization
Thursday-School Health Program
Friday -Health Activity Meeting
Saturday -Area Visit
Sunday -Holiday
Health Inspector Roles:
❖ Register the Birth and Death rates
❖ Monitor the HSC duties and its role to ensure prevention of diseases
❖ To Facilitate the Health Camp
❖ Create Awareness to the People to Control the Communicable Diseases
❖ Check water and sanitation of the village
❖ Check Aganwadi Centre
❖ Find wether Aganwadi Workers provided Healthy food to the Children
❖ To immediate action on default workers under “Health Act”
❖ To Provided plus Polio Medicine, file area tablet etc... to control the diseases
Dr. Siva Kumar Explain in relation to the Government Hospital, PHC and HSC
The government has to provide facilities for the PHC and HSC Level then the PHC s have to
function 24 hours, equipped with all facilities, including Ambulance facilities Many people
are aware of the facilities of PHC and HSCs and the scheme available for the pregnancy
women For the Muthulashmi Scheme the Govt, gives 6000 rupees for each the Pregnant
woman. The Health Inspector and the VHN s to control the Referral services, outreach
programmers, mobile clinic, and ambulance services etc.., maternal care also to be provided
in Sub Centers.
58 |
KANYAKUNIARI DISTRICT - KURUTHANGODE BLOCK
Venue :
Pioneer Paradise.
Date
21/12/2007
Nagercoil
Time: 10.00 am to 4.00
Resource Persons:
1. Fr. Joseph Justus (VHAK President )Mentoring Committee
Member
2. Dr.Shobenraj (Mentoring Committee Members)
3.
Mrs.S.Jennet Bai (State Vice President ,TN)
Guest
i.
Fr.Dominic (Mentoring Committee Members )
ii.
Dr.Gracia (Mentoring Committee Members)CHAT Nagle Health
Center
Attendees :
1. S. Sahaya Deepa (District coordinator)
2. Mrs.Vishalakshi (Kurunthancodu Block Coordinator VHAK)
3. Mrs. Saroja ( Killiyoor Block Coordinator Science Forum )
4. G. Lourds Berni (James School Of Nursing Colachal)
5. J.Daisy Rani (VHAK) Animator Kurusadi
6. N.Vincy (James School Of Nursing) Colachal
7. R.Ambika (SWAN) Monday Market
8. A.Jane Mary (CHDP) Chunkankadai
9. Mrs.Philo John (Nagle Health Center)
10. A.Mary Anitha (St.Xavier’s Nursing College)Chunkankadai
11. K.Sini (St.Xavier’s Nursing College)Chunkankadai
12. A.Mubarak Ali (VHAK)Community Organizer Edalakudi
13. J.Shenu StMary (Community College )Colachal
14. C.Catherin (Nagle Health Center Colachal CHAT
15. T.Jeya (Nagle Health Center )Colachal CHAT
16. Sahaya Stephy (St.Mary Community College)
17. Sahaya Brabitha (StMary Community College)
18. Mary Soniya (St.Mary Community College)
19. J.Chithra (VHAK Animator) Siman colony
20. R.Parkavi (Nagle Health Center) CHAT
60 | P a g
Session: 2
Facilitated by Fr. Joseph Justus
The participants were divided in to PHC Level to have a discussion on what are the activities
we are going to do, how to do and when to complete these. The entire group planned four
activities. They are
J Choosing the near by HSC and PHC villages and to have the village Profile
J How to Give the Awareness
J Conduct Village Level Meetings by choosing the resource persons.
Forming Village Health and Sanitation Committee
Vote Of thanks: with vote of thanks by Mrs. Suseela (District Coordinator Arokiyam, and
Sub Committee TNSF) the meeting came to end at 4.00pm.
59 I
21. C.Kamala (Nagle Health Center )CHAT
22. M.Uthama Thangam (P.HCenter) Kurunthancodu
23. A.Rajeswary (P.HCenter )Kurunthancodu
24. TS.Mohana Kumari (P.HCenter) Kurunthancodu
25. M.Mary Jasmine (M.C.R.T.C)
26. A.Hency Puthenthurai (VHAK) Animator
27. P.Anitha (VHAK )Animator Kurusadi
28. A.Juliet (VHAK Animator) Kurunthencodu
29. J.Mary Shahila (VHAK )Animator Kurumpannai
30. Y.Fency Jeeva Ravillai (VHAk) Animator
31. T.Thavamani (C.S.D )Monday Market
32. Thangam (C.S.D )Monday Market
33. R.Little Flower (VHAK)Animator Eranial
34. K.M.Jeyammal(VHAK) Animator Kandanvilai
Programme Schedule :
Session
Registration__________
Prayer song
Welcome Address
Introduction of NRHM.
Roles and
Responsibilities of VHN.
Lunch Break
Roles&Responsibilities
and Functions of the
Kanyakumari District
PHC and HSC.
Resource person
Mrs. Vishalakshi(Block Coordinator )
VHAK___________________________
M.PhiloJohn (Nagle Health Center)
Rev Fr. Joseph Justus (VHAK President)
Mrs.SJennet (State Vice President, TN)
2.45p.m
Group Discussion &
Presentation
Rev Fr. Joseph Justus (VHAK President)
3.50p.m
4.00p.m
Vote of Thanks
Tea Break
Mrs.Vishalakshi (Block Coordinator)
Time
10.00 a.m
11.15 a.m
1125 am
11.30 a.m
12.00p.m
l.OOp.m
1.45p.m
Dr. Shobana Raj Mentoring Team Member
61 I P Hi is
Reporn
Section: 1
Registration carried out by Mrs. Vishalakshi (NRHM Block Coordinator)
o
Total participants member is 34
o
Resource Person 3
o
Guest 2
Workshop section started with a prayer song by one of the staff of VHAK
Welcome Speech - Mrs. Philo John, Nagle Health Center staff welcomed the
Guest, Resource person and all the participants.
Introduction of NRHM: This section is carried out by Rev Fr. Joseph Justus
(VHAK President). He explained that National Rural Health Mission is a pilot
project Government may provide medical aid for the rural area poor people.
Through Government Hospital Primary Health Center and Health Sub Centers,
and it wants to mom for weather this aid really reaches the right people.For that
the Government selected five states. TamilNadu is one of the states. In
TamilNadu five Districts are selected to monitor the Government Medical
Institutions.
NRHM Project, pave ways to analyze and monitor the community and medical
institutions. NRHM project analyzed the reasons why the people are not using the
facilities offered by the Government Medical institutions. Kanyakumari District
carried out this analysis in a different manner. First it creates awareness to the
people and explains to them the Government Schemes and its benefits to the
people. Then it makes the people to visit and monitor the Government medical
institutions. NRHM Project gives awareness to the grassroots level people also to
monitor the government aided activities.
The project concept is not to blame anybody or to find the causes for the failure of
the Government institutions. The only aim is to ensure that the Government
medical schemes reach the rural people through Government medical institutions.
Expectation of NRHM Project
To eradicate the Infant Mortality
To eradicate the Infant Mother’s Mortality
To remove the hindrance and ensuring Basic facilities to the rural
people welfare
To eradicate open toilet system
To eradicate Communicable Diseases
To accomplish basic Facilities to the G.H, PHC, and HSC.
Mrs. Jennet Bai, State Vice President VHN Association, TamilNadu distributed a catalog on
the list of the services available at the sub-centers, PHCs and also she explained about the
VHN Roles.
62 |
age
VHN Roles:
A
❖ Data collection about Village population, pregnancy list, newly married
persons, death and New Birth.
♦> To Regulate the Pregnancy registration
❖ To visit the mother and child thrice in a month immediately after delivery.
❖ Providing Maternal Health, Antenatal care, intranatal care and postnatal care.
❖ To Give Awareness about the Health and Nutrition, Normal Delivery and
Institutional Delivery
❖ Awareness and ensuring of immunization for the new bom child
❖ D.T.P and Polio Drop
VHN Duty Chart
Monday -Pregnancy Test
Tuesday -Review
Wednesday -Immunization
Thursday-School Health Program
Friday -Health Activity Meeting
Saturday -Area Visit
Sunday -Holiday
Health Inspector Roles:
❖ Register the Birth and Death rates
❖ Monitor the HSC duties and its role to ensure prevention of diseases
❖ To Facilitate the Health Camp
❖ Create Awareness to the People to Control the Communicable Diseases
❖ Check water and sanitation of the village
❖ Check Aganwadi Centre
❖ Find wether Aganwadi Workers provided Healthy food to the Children
❖ To immediate action on default workers under “Health Act”
❖ To Provided plus Polio Medicine, file area tablet etc... to control the diseases
63 |
Dr. Sobena Raj
He was talking about the Present Conditions of the HSC and PHC in the Kanyakumari
District and he explained the Government schemes for pregnant women, below poverty line
people schemes, health and nutrition etc... Then he explained about the facilities available,
improvements needed in Government Hospitals.
Session: 2
Group Discussion: Facilitated by Fr. Joseph Justus
The participants were divided in to PHC Level to have a discussion on what are the activities
we are going to do, how to do and when to complete these. The entire group planned four
activities. They are
V Choosing the near by HSC and PHC villages and to have the village Profile
J How to Give the Awareness
S Conduct Village Level Meetings by choosing the resource persons.
V Forming Village Health and Sanitation Committee
Vote Of thanks: with vote of thanks by Mrs. Vishalakshi (Block Coordinator) the meeting
came to end at 4.00pm.
64 | P a g <’
PERAMBALUR DISTRICT WORKSHOP-TOT REPORT
Venue : Christian Nursing College, Vengateshapuram, Perembalur
Date : 21st & 22nd December 2007
Attendees :
Participants Name
S.No
Mrs. Mithra, Executive
1
Director, Dawn Trust,
_______ Block
Perembalur
______Organization
Dawn Trust, Perembalur
2
Thirumanur
Sagayamatha Hospital,
Thirumanur
Sagayamatha Hospital.
Thirumanur
Sagayamatha Hospital,
Thirumanur
Sagayamatha Hospital,
Thirumanur
Sagayamatha Hospital,
Thirumanur
Sagayamatha Hospital,
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
Mr. I. David, Field Officer.
Pullambadi, Thirumanur
Mr. S Antonysamy. Field
Officer, Pullambadi,______
Mr. A. Arockiadoss.
Thirumalapadi, Ariyalur
MR. M. Antony, Valar
Kazhvi Iyyakkam,
Kulamanickam, Ariyalur
Mr. VA. Arockiasamy,
Makkal Nala Paniyalar,
Kulamanickam, Ariyalur
Mr. S. Antonysamy, Ex,
Panj ayat President,
Senbiakudi, Thirumanur
Mr. V. Balaiya,
Keelaveedhi, Kurumbalur,
Perembalur_____________
Mrs. P. Eswari, Siruvachur,
Ariyur, Perembalur______
Ms. Sasikala, Christian
Nursing College_________
Ms. M. Kumar, Cencheri,
Perembalur_____________
Ms. R. Valarmathi,
Cencheri, Perembalur____
Mrs. Amsavalli,
Pereyakarkka, Perembalur
Mrs. Rasaiyal,
Pereyakarkka, Perembalur
Mrs. T. Kanagavalli,
Pereiyakarkka, PER______
Mrs. S. Sumathi, OS Al,
Andimadam____________
Mr. G. Selvam,GGS,
Jeyankondam___________
Mrs. K. Thenmozhi,
| Jeyankondam
65 |
19
43
Mrs. V. Amutha,
Idaiyarkurichi__________
Mr. A. Sankar,
Idaiyarkurichi__________
Mr. K. Vijayakumar,
Thennur, Andimadam
Mrs. Reetha Mary,
Thennur. Andimadam
Ms. P. Amala,
Varatharajanpet, Ariyalur
Ms. K. Jeya Ganthi,
Kuruvadi, Thirumanur
Mrs. K. Thenmozhi,
Thrirumanur, Ariyalur
Mr. Gurunathan,
Elunatchipuram,________
Mr. P. Thangaiyan,
Elunatchipuram. ________
Mrs. Jothimani,
Kurumbalur, Perembalur
Mrs. Parameshwrari,
Kurumbalur, Perembalur
Mrs. Roseline Alex,
Sannamangalam
Mrs. J. Catherine_______
Kirs. P. Kala, Senjery,
Perembalur____________
Mrs. A. Chithra, Senjery,
Perembalur____________
Ms. K. Krithiga,
Perembalur____________
Mrs. P. Nirosha, Senjeri
Post, Perembalur_______
Mrs. Rasathi, Nerkunam,
Perembalur____________
Mrs. E. Malathi.
Kalarampatti, PER______
Ms. N. Sathiya, PER
Nirs. Vanitha, PER______
Mrs. G. Subeetha PER
Mrs. R. ThenkarJ_______
Mr. V. Jeyachandran John
Turor, Christian Nursing
College, PER__________
Dr. M. Madhavan
44
45
Mrs. S. Rajababu_____
Mrs. Alli Porselvi, PER
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Thirumanur
SHWET
Thirumanur
SHWET
Thirumanur
SHWET
Thirumanur
SHWET
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Perembalur
Andimadam
Dawn Trust____________
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Andimadam
Gandhi Gramodhaya Trust
Perembalur
Dawn Trust
Perembalur
Dawn Trust
Peremabalur
Peremabalur
Peremabalur
Perembalur
Peremabalur
Dawn Trust
Dawn Trust
Dawn Trust
Dawn Trust
Dawn Trust
Managing Trustee,
VRM Trust Perembalur
Peremabalur_________
Peremabalur
Dawn Trust
Dawn Trust
Dawn Trust
66 | P age
11.50 a.m.
Community Monitoring - perspective from the field
12.15 p.m.
Community Monitoring - perspective from the field
12.30 p.m.
12.45 p.m.
Open discussion
Vote of Thanks
1.00 p.m.
2.00 p.m.
Lunch__
Provision of Equitable, quality health services for the
poor: Principles and practices
3.00 p.m.
Introduction to NRHM & Community Monitoring at
Tamilnadu level and Peremblaur District level
4.00 p.m.
4.15 p.m
Tea Break___________________________
Community Ownership-community mobilization
community’ monitoring
8.00 p.m
Supper
Council President, PLR
Dr. Bhanumathi, MS,
Superintendent Retired &
IMA member, Perembalur
Dr. Mathiazhagan, MS, JD
Retired, Jeyakondam
Mrs. Mithra, Executive
Director, Dawn Trust,
Perembalur
Mr. Soosai, Chairman,
Gandhi Gramodhaya Trust,
Andimadam._____________
Dr. Bhuveneshwari, MBBS,
DGO, Private Practice,
Perembalur
Film show and discussion
Dr. Christopher, Managing
Trustee, DAWN Trust, PER.
DAY 2-22.12.07
Time
8.00 a.m.
9.00 a.m.
9.15 a.m.
Session__________________________________
Breakfast______________________________ __
Sharing on Previous day happenings & discussion
Personal Sharing on NRHM
11.00 a.m.
11.15 a.m.
11.45 a.m.
Health - Basic Human Right______________
Questions from Participants_______________
Personal Sharing on community monitoring &
Introduction to Tools for monitoring________
Study of Tools in Groups - Block wise______
Tea Break_____________________________
Feedback from the participants about the tools
12.15 p.m.
Committee Formation
12.45 p.m.
Roles and responsibility of various committees
1.45 p.m.
2.15 pun.
2.45 p.m.
3.15 p.m,
3.45 p.m.
Lunch_________________________________
Village Report Card_____________________
Preparation of Action Plan - Group Discussion
Sharing of follow up activity plan___________
Valedictory Function
9.30 a.m.
9.50 a.m.
10.00 a.m.
Resource Person
Dr. Kulandaivelu Pandiyan,
Tamilnadu Science Forum
Mr. Martin, Advocate, TRY
Dr. Rakhal & Franks Xavier
Dr. Mathiazhagan, MS
Mr. Martin ML
Sr. Jesse________________
Mr. Bethaperumal, SHWET,
Thirumanur, Block Coord
Mrs. Mithra, Executive
Director, DAWN Trust
Dr. Rakhal
Sr. Jesse
68 | P ag
Report:
First Day - 21,12.07 Inaugural Session 1030 AM - 130 PM
The workshop started at 10.30 AM with a small introduction to Community Based
Monitoring process and the implementation of this at Perembalur District. Sr. Jesse, CHAT,
Executive Director introduced the project and extended a warm welcome to all participants,
guests and resource persons.
Mr. Christopher, Chairman, Christian Nursing College, Perembalur, in his presidential
address emphasized people’s participation in this project and welcomed the initiative by the
Government. He persuaded the participants to take this message to the people in the villages
to make use of the government resources making aware of their health needs.
Dr. Bhanumathi, IMA member at Perembalur and a special invitee for the workshop shared
her experiences of having served the people as Superintendent in Government Hospital,
Perembalur. Aim of NRHM is to reduce IMR and MMR, as well as to increase the usage of
government facilities for the people. For which Govt, services aim at increasing Institutional
deliveries and quality care for the people. In short Government provides very good services
and facilities and we must make the people aware for proper use of these services.
Nir. Selvaraj, Gudalur, was invited to share his experiences on Community Monitoring. He in
his sharing put forward some of his thoughts for the participants to think further.
❖ Health necessarily includes Employment and Education
❖ It is a shared responsibility of Government, Government Officers and the People.
❖ Concentration not only on Pregnant Women but also before pregnancy on
Environment, Nutrition, water and land.
❖ Committees must not only concentrate on curative aspect and services provided by the
Government but also on the causes of diseases.
❖ People are to be made aware that they are the responsible persons to safeguard their
own health. In such a way they must control the mosquito increase, remove the
wastages to a proper place, proper sanitation etc.
❖ This awareness could be taken to the people through art, music and drama.
❖ He highlighted the usage of plastics and how plastics become the cause of many
sicknesses in health area.
Dr. Gandhimathi, Joint Director, Health and Family Welfare Department, Perembalur,
inaugurated the Workshop and said it is by the joint venture of Government, NGOs and
People, we will be able to attain expected results in Perembalur District. She said that:
❖ Mothers Maternal Death must be reduced
69 | P s § -
❖ Infant Mortality Rate must come down
❖ Awareness to the people on TB. HIV/AIDS should be given
She also said that we have reached the NRHM standard and comparatively we are much
better than other people in other States.
After her talk we invited Mr. Kamaraj, President, Consumer Council, Perembalur to share his
experiences on attaining Health Services. While sharing main points he focused are:
❖ People must receive bills for any commodity, service that he gets from other agencies.
This awareness must be given to the people first.
❖ He requested other to contact District Consumer Council Forum if any thing goes
wrong somewhere. Even Government Services must keep record of treatment they are
recommending for the patient.
❖ If service is denied also you can suit a case in the consumer council court. Hence he
requested all the participants to make aware the people on these rights to get quality
health services for them.
During the experience sharing there were lot of discussions and clarifications. Every one
participated fully and they were eager to learn on Community Monitoring.
After that Mrs. Mithra, Executive Director, Dawn Trust, came forward to thank Government
Officers, Special Guests and other Resource persons for their guiding presence. With that the
inaugural session came to an end at 1.45 pm.
Post Lunch Session 2.30 - 4.00 PM
Introduction to NRHM - Community Monitoring at Tamilnadu and Perembalur Level
2.30 - 3.00 Dr. Buvaneshwari, District Mentor and a Private Medical Practioner, introduced
❖ Community Monitoring Project under NRHM,
❖ Its aim and objectives, and
❖ The activities to be carried out.
She also explained the community monitoring processes from national, state and
district level to block level.
3.00-4.00 Block level Group Discussion on Provision of Equitable, quality health services
for the poor.
Principles and practices :
Participants were divided into three block level groups and they were given two questions
regarding equitable quality health services for the poor: in Principles and practices. They
discussed for about half an hour after which they shared their views for clarifications. The
outcomes were:
70 | P a ' e
❖ Basic facilities such as reception, kind words and concern without caste, creed and
colour.
❖ Medical officer who is available 24 hours and for certain duration without being
frequent transfers.
❖ Ambulance facilities in all PHCs and to the village in need.
❖ Awareness to the people on not wasting the medicines supplied by the Government.
❖ Good building so as to have facility to accommodate at least one female and one
male nurse in the Sub-center and PHC premise.
❖ Medical report for any kind of disease for the people.
❖ Facility of having mobile clinic.
❖ Waiting Hall for patients and attendees in all PHCs and Hospitals.
❖ In absence of a Doctor, responsible Nurse be able to treat and to refer the patients.
❖ Kindness and approachability
Life saving drugs must be kept in all PHCs in advance.
In practice all these are lacking in sub-centers and in PHCs. After the sharing we dispersed
for tea break.
4.15 - 6.00 pm: Film Show on Three Case studies who did not get proper health care
The Video Film was in Hindi but we were able to translate it in local Tamil for the
participants to understand better. The Show went on till five and after which we had open
discussion and sharing of same experiences in their own villages. After this we had next day
planning and dispersed at 6.00 pm.
2ad Day-22.12.07
9.00 - 9.45 am: Community Ownership, Community Mobilization and Community
Monitoring
With little introduction to today’s happenings, Mr. Antony, from Thirumanur Block took
over to read out the report on previous day workshop. After a small discussion and
clarification the report was approved.
After that Dr. Christopher, Chairman, Dawn Trust came over and explained about the
community ownership. He interpreted that this NRHM community monitoring under NRHM
is an opportunity for all village people to have ownership of our own and realize that we are
funding for the services and we have every right to monitor the activities. He connected
previous day discussion on film show and our day-to-day experiences in health care services
in Tamilnadu. To reduce the gap between principles and practices we people need to monitor
the process, results and plan for the future so that everybody will get assurance of having
health — now. Every NGO is good enough to organize and mobilize the people towards this
process and we need to plan together to attain this goal.
9.45 -10.30 Committee Formation and Roles and Responsibility of various Committees
Mrs. Mithra, Executive Director, Dawn Trust explained about how Community Monitoring
will be possible. It is through formation of committees in all levels with various roles and
responsibilities. She started from
71 | P a g e
• National level AGCA, Mentoring Committee,
•
State Mentoring Committee,
• District Mentoring Committee,
•
Block level Community monitoring and Planning Committee,
•
PHC level Community monitoring and Planning Committee and
• Village Health and Sanitation Committee. (VHSC)
Regarding committee members she made the participants to explore and suggest persons
from lower level to higher level. Thus they themselves came to an understanding of having
triangular partnership of people, people’s representatives, PRI, NGOs, CBOs, SHGs, and
Health Service Providers. She also explained about roles and responsibility of various
committees.
10.45 -1230: Introduction to Tools - Dr. Rakhal
After forming various committees how are we going to do community monitoring. Project
document has given us some tools and on applying these tools we will get a very good
assessment on which we will be able to plan in all levels of health services. He started
explaining from Village Health Profile, and what are the areas to be looked into.
After getting the village health profile we need to discuss them with village people after
which we will be able to form the Village Health and Sanitation Committee. The committee
will state collecting data from various angles such as: Group discussion with Village people
in general. Group discussion with Village women in General, Group discussion with
Marginalized women, Personal interviews with beneficiaries. Medical Officers, Direct
observance of sub-centers, Primary Health Centers, Block Health Centers and District
Hospitals. Data will be collected on Disease Surveillance, Curative services, untied fund,
adverse outcome, case study etc
This session went on with discussion and clarification. Participants were enthusiastic and
amazed on looking at government health care promises and welfare schemes.
1230 - LI5 pm - Health is our basic Human Right - Mr. Martin, Advocate, FEDCOT
Mr. Martin, Advocate from Trichy came over to explain that Health is our Basis Human
Right. Government has endowed this responsibility of monitoring health services with people
and has asked them to plan for the future. It is really to be welcomed and each of you is a
Health Minister. Each citizen has the responsibility of watching, supervising what is
happening in service sectors because it is people’s money. We are paying for the health
providers and personals. He promised his support in implementing the project at Perembalur.
72 | P a g e
Post Lunch Session: 2.30 - 3.00 pm Preparation of Action Plan and sharing: Group
Discussion
After the Lunch the participants were divided into three block wise groups for discussing
follow up activities regarding and came with following tentative activities and dates:
Activity_______________
District Workshop at Block
level,__________________
Place of Workshop
Meeting Government
officers____________
Whom Shall you meet
Meeting Village people
Choosing PHCs
Choosing Village for
forming VHSC~
Village Level Meeting
Perembaiur Block
28.12.07
Thirumanur Block
29.12.07
Andimadam Block
27.12.07
Christian College,
Perembalur_____
24 & 26^
RC Church,
Thirumanur
Taluk Office,
Andimadam
23rd & 26th
Block Medical
Officer, SHG
leaders, VHN,
NGOs, ANC &
PNC, Panjayat
President,
PHC Medical
Officer, Village
President, VHN,
Parish priest,
Volunteers
26th & 27th
Ammapalayam,
Kurumbalur,
Kalpadi__________
Senjeri, Kurumbalur,
Perembalur south,
Perembalur North,
Thuraimangalam,
Kalpadi, lyleer,
Siruvachur,
Elambalur,
Sengunam,
Pommanapadi,
Sathiramanai, Velur
26th - 28th
Thirumanur,
Venganur &
Kuruvadi________
Thirumanur,
Karaipackam,
Kandirathitham,
Senabathi,
Thirumalapadi,
Sembiakudi,
Kulamanickam,
Elandakudam,
Vilagam, Sannavur,
Kuruvadi, Kovilur,
Sullangudi,
Elackurichi,
Kamarasavali,
Block Medical
Officer, Panjayat
Chairman, Village
president, SHG
leaders, Ward
members, VHNs,
Health Inspector,
24th-26th
7th - 1January
Edayankurichi,
Andimadam,
Varatharajanpet
Edaiyakurichi,
Silambur, Aiyyur,
Kuvagam,
Vilandhai,
alagapuram,
P.Kurichy, Olaiyur,
andimadam,
Periyathathur,
Varatharajanpet,
Kavarapalayam,
Karukkai
By 20th January
Valedictory Function
After sharing these activities and plan Mr. Francis Xavier, District Coordinator, heart fully
thanked all the participants from all blocks and villages for their active involvement in the
workshop. He thanked also all government officers, guests and resource persons for their
dedicated service and presence. With that the workshop came to fine end. Thank you.
73 | - a g e
District Map :
Perambaiur District
Blocks
7
X
i
\
10 km
Veppanthatta.
/
Veppur
N
tb
Andimadarh 5
V-
Sendurai/
I
Perambaiur
Jayankondart
/
T.Palur
©GISNIC-TNSU
74 | Page
1
PERAMBALUR DISTRICT - PERAMBALUR BLOCK
Venue: Christian Nursing College Campus, Perembalur
Date: 28.12.07
Time: 10.00 am - 4.00 pm
Attendees: 150
Guests:
1. Nir. Ilaiyaraja, Panjayat President, Perembalur
2. Dr. Ramesh, BMO, Perembalur
3. Dr. Bhanumathi, Retired Superintendent & IMA member, Perembalur
4. Dr. M. Christopher, Chairman, Christian Nursing College, Perembalur
5. Mrs. Amalorpava Mary, CHN, Perembalur
6. Mr. Karunanithi, Mrs. Eshwari & MR. Marikannu, Warn members, Perembalur
Resource Persons:
1. Dr. Mrs. Bhuveneshwari, MBBS, Mentor, Perembalur
2. Mrs. Mythra, Dawn Trust, Perembalur
3. Mr. Francis Xavier, Dist. Coordinator, CHAT, Trichy
4. Ms. Thamilmani, Lecturer, Christian Nursing College, Perembalur
5. Mrs. Chithra, Mrs. Carolin, Mrs. Mercy Joy & Mrs. Senthil Vadivu - Tutors,
Perembalur
Agenda:
1. Registration
2. Inauguration
3. Introduction to Community Monitoring and Planning
4. Committees and their roles and responsibilities
5. Functions of sub-centers & PHCs
6. Applying Tools
7. Village Report Card
8. Valedictory function
75 | P a g *
Report:
Community Based Monitoring and Planning Project Workshop under NRHM started at 10.00
am. Mr. Prabhakaran, Dawn Trust welcomed the participants and guests.
Dr. Christopher, Chairman, Christian Nursing College, introduced the community monitoring
and requested all the participants to get fully involved in implanting this project as it is the
need of the people to get healthy living and surrounding.
Mr. Ilaiyaraja, Panjayat President, in his presidential address pictured how government
delivers health services to the poor and how many welfare schemes are planned for the
people. He requested all the participants to make aware these things to the people to make use
of the available services and promised his support for all efforts taken to assure these
services.
Dr. Ramesh, Block Medical Officer, Ammapalayam, Perembalur explained the services
available at PHC and Sub-center level.
After the introduction of NRHM all the PHCs have become 24 hours centers,
equipped with facilities,
❖ Ambulance facility is available at PHC level. If the ambulance is not ready we pay for
the transport. The Pregnant women are brought to the PHC safely and during stay we
provide food.
❖ And after delivery the Government provides nutritious food to the mothers during
lactating period.
Under Muthulashmi Scheme the Govt, gives 6000 rupees for the woman to get
nutritious food during 7-9th month of pregnancy and during first three months of
lactating period.
❖ Under JSY to encourage institutional deliveries government provides 500 - 700
rupees for the woman to meet out the expenses during deliveries.
❖ Previously at PHC only 5 to 6 deliveries were conducted per year but after the NRHM
now we are conducting 15 to 20 deliveries per month. Hence institutional deliveries
have increased.
Government Hospitals are competing with other Private Hospitals. Introduction of
Beomonc and CeMone centers the services to the people are more available and all
the people are using the same.
After his talk Mrs. Amalorpava Mary, CHN explained her duties and responsibilities:
❖ Monday - examining pregnant women, weighing and checking the growth of the fetus
and counseling the women.
❖ Tuesday - Meeting at PHC to plan for the next week
76 | P a g e
❖ Wednesday - Immunization day
❖ Thursday - School Health Day
❖ Friday & Saturday - awareness to the people regarding family planning and health
and hygiene.
❖ Registration of Pregnancy
❖ During first six months, monthly once checking the mother and fetus, weighing and
health awareness.
❖ During 7th and 8th months once in fifteen days the woman must come to have medical
check up in PHC.
❖ During 9th months weekly check up to have normal safe delivery.
Dr. Bhanumathi in her special talk explained the aim of NRHM to introduce this community
monitoring namely to reduce IMR and MMR. Village women must be made aware of the
health services available at PHCs and encouraged to have institutional deliveries in time by
which we will be able to reduce the same.
Post Lunch session:
After the lunch Ms. Tamilmani, Lecturer, Christian College, tried to emphasize the functions
of sub-center and PHCs, namely mother and childcare, curative services for the common
diseases, referral services, outreach programmes, mobile clinic, ambulance services,
conducting deliveries etc.
Followed by there were clarifications from the audience and Dr. Bhuveneshwari, Mentor,
cleared those clarifications. Then we switched on to introducing the Tools for Community
Monitoring.
Ms. Mercy - Group discussion with Community members in General, Disease surveillance.
Curative services, untied fund flow,
Ms.Senthilvadivu - Group discussion with Village Women & marginalized women group,
child health services, quality of care, adverse outcome
Mrs. Chithra — interview with Beneficiaries, Maternal Health, details of Muthulakshmi Reddy
Scheme, Janani Sraksha Abiyan, adverse outcome, denial of services
Mrs. Catherine - Documentation of any denial of health care
And Mr. Francis Xavier, District Coordinator, consolidated and clarified all the doubts
regarding tools and exposed the faculty checklists for Sub-centers, PHCs, Community Health
Centers and Score Cards and sharing these results with the people in all levels.
Dr. Bhuveneshwari came forward to explain how to prepare Village profile initially and
Village health report card at the end.
77 | P age
Action Plan
We divided the Group in to three according to the PHC to have discussion on what are the
activities we are going to do, how to do and when to complete these activities. The entire
group planned four activities namely:
• Meeting the village people,
• Meeting the village heads and explaining to them regarding community
monitoring under NRHM,
• Completing Village profile and
• Forming Village Health and Sanitation Committee.
Time Frame: All these activities will be completed by 7th January 2008.
Mr. John, Lecturer, Christian College, thanked all the participants, guests and resource person
for their availability and encouraged all the participants to work towards achieving
community monitoring project successful. With that the workshop came to an end. Thank
you.
78 | P a s e
PERAMBALUR DISTRICT - TIRUMANUR BLOCK
Venue: RC Chruch Campus, Thirumanur
Date: 29.12.2007
Time: 11.00 am - 4.00 pm
Attendees: 35
Guests:
1. Mrs. Rajeshwari, Panjayat President, Thirumanur
2. Mr. Arockiaraj, Managing Director, SHWET, Elackurichi
Resource Persons:
1. Mr. Francis Xavier, Dist. Coordinator, CHAT, Trichy
2. Mr. Bethaperumal, Block Coordinator, Thirumanur
Agenda:
1. Registration
2. Inauguration
3. Introduction to Community Monitoring and Planning
4. Committees and their roles and responsibilities
5. Functions of sub-centers & PHCs
6. Applying Tools
7. Valedictory function
Report:
Community Based Monitoring and Planning Project Workshop under NRHM started at 11.00
am. Mr. David, Field Officer, Sagayamatha Hospital welcomed the participants and guests.
Mrs. Rajeshwari, Thirumanur Panjayat President, in her presidential address pictured how
government delivers health services to the poor and how many welfare schemes are planned
for the people. He requested all die participants to make aware these things to the people to
make use of the available services and promised her support in implementing this project and
for all efforts taken to assure these services.
Mr. Arockiaraj, Managing Director, SHWET enumerated services available at sub-centers
and PHCs of our areas.
79 | Page
❖ PHCs have become 24 hours centers, equipped with facilities,
❖ Ambulance facility is available at PHC level. If the ambulance is not ready they are
supposed to pay for the transport. The Pregnant women must be brought to the PHC
for safe delivery and during stay provision of food.
❖ And after delivery the Government provides nutritious food to the mothers during
lactating period.
Under Muthulashmi Scheme the Govt, gives 6000 rupees for the woman to get
nutritious food during 7-9^ month of pregnancy and during first three months of
lactating period.
❖ Under JSY to encourage institutional deliveries government provides 500 - 700
rupees for the woman to meet out the expenses during deliveries.
❖ Proper immunization. Mother and Child care, curative services must be available at
all PHCs,
❖ Referral services, outreach programmes, mobile clinic, ambulance services,
conducting deliveries
Mr. Bethaperuamal explained various duties of VHN to the participants:
•
Monday - examining pregnant women, weighing and checking the growth of the fetus
and counseling the women.
• Tuesday - Meeting at PHC to plan for the next week
•
Wednesday - Immunization day
•
Thursday - School Health Day
•
Friday & Saturday - awareness to the people regarding family planning and health
and hygiene.
Registration of Pregnancy. During first six months, monthly once checking the mother
and fetus, weighing and health awareness. During 7th and 8th months once in fifteen days
the woman must come to have medical check up in PHC. During 9th months weekly
check up to have normal safe delivery.
Post Lunch session: Committee Formation
Bethaperumal continued to explain on formation of Committees at various level. First in the
selected villages forming Village Health and Sanitation Committee, proceeding to form PHC
level Community Monitoring and Planning Committee, and then to Block Level Community
Monitoring and Planning Committee Formation. Explained also regarding who are all can be
in the committee namely : Government Health Service Providers, PRI representations, NGOs,
CBOs, SHG leaders and Village people, ANC, PNC, Marginalized representation. Committee
must assure 50% women participation.
80 ] P a 5
Monitoring Tools
And Mr. Francis Xavier, District Coordinator, Explained about tools and had very good
discussion with the participants. He clarified tools regarding having:
•
•
•
•
•
•
Group discussion with Community members in General, Disease surveillance.
Curative services, untied fund flow,
Group discussion with Village Women & marginalized women group, child health
services, quality of care, adverse outcome
Interview with Beneficiaries, Maternal Health, details of Muthulakshmi Reddy
Scheme, Janani Sraksha Abiyan, adverse outcome, denial of services
Documentation of any denial of health care
Regarding tools and exposed the faculty checklists for Sub-centers, PHCs,
Community Health Centers and Score Cards and sharing these results with the people
in all levels.
Explained how to prepare Village profile initially and Village health report card at the
end.
Action Plan
We divided the Group in to three according to the PHC to have discussion on what are the
activities we are going to do, how to do and when to complete these activities. The entire
group planned four activities namely:
• Meeting the village people,
• Meeting the village heads and explaining to them regarding community
monitoring under NRHM,
• Completing Village profile and
• Forming Village Health and Sanitation Committee.
Time Frame: All these activities will be completed by 15th January 2008.
Mr. Antonysamy, Sagayamatha Hospital, thanked all the participants, guests and resource
person for their availability and encouraged all the participants to work towards achieving
community monitoring project successful. With that the workshop came to an end. Thank
you.
81 | P a g e
TIRUVELLORE DISTRICT WORKSHOP-TOT REPORT
Venue
: Poondy Govt.Higher Secondary school - Tiruvallur district
Date
: 26 & 27- December407
No. of Participants : 42
Report:
26tb December’07
Tiruvallur is one among the five districts where the community monitoring and planning
project implemented. All the five districts have done two days district workshop. The
Tiruvallur district workshop is a residential workshop.
The workshop started on 26th morning with the inauguration program. The workshop
inaugurated by the Poondy panchayat president Mr.Amburose who extends his cooperation to
the CMP team. Dr.Sampath, Deputy Director of Public health services, Tiruvallur district
participated in the inauguration. He explained the facilities available in PHCs and sub
centres, the importance of public health services in villages and the importance given to local
self-government in NRHM. He also explained the untied funds available to PHCs, sub
centres and village committees. He assured his cooperation to this process. Few other
eminent personalities of the district also participated in the workshop.
Immediately after the inauguration, Mr.Karuna from right to food campaign explained the
objectives of the workshop. Mr.Kavitha from Tamilnadu science forum explained the group
about the process of CMP in Tamilnadu. Karuna explained the different stakeholders in
NRHM, different group’s roles and responsibilities in NRHM and community monitoring.
Ms.Latha the district mentoring committee member explained the importance of community
monitoring, the ways to improve the quality of health services through monitoring and the
importance given to community monitoring in this project.
Karuna took a session on how to form committees in villages. He shared the experience of
social audit for National Rural Employment Guarantee scheme in Villupuram district. He
assured the success of community monitoring will result in improving the services.
The district mentoring committee member Dr. Ilango, take a session on Health and Local
self-government. He explained the role of Local self-government representatives in health
activities.
27th December’07
The second day session started with the lecture on education and health in Tiruvallur district.
Mr.Kamalalayan, district coordinator, Arivoli lyakkam handled the session. He shared the
education and health services status of Tiruvallur district. He emphasized that the need of
community to understand health as a right and it is a duty of the government to provide
quality and equity health services.
82 | P a g e
Followed by that session. Ameerkhan of Makkal nalavalvu iyakkam took a session on health
rights. He explained the project tools in the light of health rights. He explained the rationale
behind the tools, the objective of the entire process and the few issues taken for monitoring.
The group was asked to five more emphasize on the system improvement and the system
lacks and to give less importance to individual staff member s mistakes.
The entire group has divided into three based on their own blocks. The group discussed the
tools in detail with the help of the translated version of the tools. All the groups asked to give
their feedback on tools in detail. The groups gave extensive feed back on each topic.
After this session, the district mentoring committee member Mr. Thenpandiyan deliver
lecture on ‘Health and Human rights’. He argued why health should become as a fundamental
right constitutionally. After this session, the group planned the strategies to run the block
level workshops.
District Map:
Thiruvailur District
Blocks
5
pummidipundi
15 km
0
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r
’ \
Pallipattu
Poondil
Tiruvelangadu
Jiflinjur
’E!,apuram
Al
!
z X I -J
y Tiruvaiy
lam
©GISNIC-TNSU
83 | P a g-£
TIRUVELLORE DISTRICT - KUMIDIPOONDI BLOCK
Venue
: Matharpakkam - Tiruvallur district
Date
: 02/02/2008
No, of Participants : 42
Report:
Gummidipoondy block workshop on community monitoring and planning held on 2
January'’08 with 42 participants in whom 32 members are from the community who will take
this process further. The Gummidipoondy block is one among the three blocks in Thiruvallur
district, which chosen for community monitoring and planning project
The workshop started around ll.a.m with inauguration. The panchayat president
Ms.Sakunthala gajendiran inaugurated the workshop. The eminent personalities of this block
were participated. The block coordinator for this project Ms. Kala gave welcome address.
The Tiruvallur district coordinator Mr. Devaraj explained the objectives of this workshop. He
explained the project related activities and process held in Tiruvallur district. He also
explained the objectives of the community monitoring in NRHM.
Mr. Suresh, the state joint coordinator of this project explained the importance, effectiveness,
opportunities and the success of community monitoring. He emphasized the rights of the
people in health care services and this one of the process to improve the quality of the health
care services he added.
Mr. Dhayanidhi health inspector from Kannankottai PHC shares the facilities available in
PHC and he explained the roles and responsibilities of the service providers. Followed by
him Suresh explained the process of CMP at the state level and in other districts.
Afternoon the group was divided into three small groups; Suresh introduced the tools to
groups. He explained the logic and the issues taken for survey. After that, the small groups
discussed the tools and expressed their opinion on tools.
As a final activity, the small groups for each PHC planned the strategies to form the village
health and sanitation committee. The workshop ended at 5.00.p.m.
84 | P a g e
TIRUVELLORE DISTRICT - MEENJUR BLOCK
Veiwe: Thadaperumbakkam panchayat community hall, ponneri
Date: 04-01-2008
Program:
Programme headed by:
Mrs. Eeswari raja (Minjur block chairman)
Mrs. Manimehalai (thiruvallur dist. Counselor)
Welcome address by:
Mr. Muthu.D (Jeeva jyothi organizer)
Project explanation by:
Mr. Arul.s (NRHM CM&P B.Coordinator)
Training agenda by:
Mr.Devaraj .R (NRHM CM&P D.Coordinator)
Greeted by:
Dr.P.Saravanakumar Medical officer (Minjur PHC)
Dr.Mohanraj Medical officer (Kattur PHC)
Dr.Rajan
Doctor (devampattu PHC)
Mrs.N.Jamuna
Vote of thanks by:
President, thadaperumbakkam panchayat
Mr.Senthilkumar (Jeeva jyothi document, officer)
Schedule:
10.30 am
11.00 am
11.30 am
11.45 am
12.45 am
1.00 pm
2.00 pm
2.30 pm
330 pm
4.30 pm
Tamilnadu science forum and makkal nal vaalvu iyyakkam
importance of NRHM CM&P
tea break
people role in monitoring
services for health
lunch break
introduction of tools
group discussion
planning
session closing
85 | P age
Guests:
S.No
1__
2
3
4
Name___________
Mrs. R.Eeswari raja
Mrs.Manimegalai
Mrs.sumathi______
Mrs.jamuna
Designation___________
Minjur block president
Thiruvallur dist councilor
Block councilor_______
Panchayat president
address
ponneri
Ponneri
ponneri
Ponneri
Following special guests are participated in the training:
Name____________
J__ Dr.P.Saravanakumar
2 ___ Dr.Mohanraj______
3 __ Dr .Raj an_________
4 ___ Mr.ameerkhan_____
4 ___ Mr.Rajeshkannan
5 ___ Mr.P.Victor_______
6 __ Mr.jayachandran
7 ___ Mr.gajendran______
8 ___ Mr.ponko muthu
9
Mr.M.P.Sekar
S.No
Designation______________
Medical officer (Minjur PHC)
Medical officer (Kattur PHC)
Doctor (devampattu PHC)
MNK state co convener_____
Panchayat assistant________
Director, VSST___________
Press reporter_____________
Press reporter_____________
Press reporter_____________
Social activist
address
Minjur
Katiur
Devampattu
Chennai
Ponneri
Pulicat
Minjur
Minjur
Ponneri
Methur
Participated target village members are followed:
S.No Name_______
j___ Balaji_______
2 ___ Subramani
3 __ Ramesh______
4 ___ Moorthy_____
5 ___ Sunkumar
6 __ Vedhanayagi
7 ___ Ramani
8 ___ Pushpa______
9 __
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Suriyakala
Devika______
Kalaiseivi
Alimabeebee
Majitha______
Sahirabanu
Kala________
Rahthi_______
Lakshmi_____
Anbarasi_____
Thavamani
Bhuvaneshvari
Meena______
Akila_______
Suguna
village__________
Kanchivayal______
Karimanal_______
Senjiyamman nagar
Pasiyavaram______
Pasiyavaram______
Lighthouse_______
Ambedkar nagar
Kolur___________
Kolur___________
Kottaikuppam
Kottaikuppam
Rahmath nagar
Pulicat__________
Pulicat__________
Kolur___________
Ragavareddy medu
Sirulapakkam
Seganyam_______
Periyakarumbur
Periyakarumbur
Kattur__________
Kattur__________
Annuppampattu
86 | p a g e
Report:
NRHM - Minjur block training wras conducted on 1st January 2008, nearly 22 village
representatives were participated in this training, and training was inaugurated by Minjur
block chairman and Thiruvaliur district councilor.
After inaugural function training session was started, three PHC doctors were present and
gave lot of input about PHC functions and duties of doctors and also their difficulties.
Than village members also interact with doctors and clarify their doubts. Than discussion
started about monitoring, villagers were said their view’s and finally they one conclusion for
Community monitory' and planning and also the importance of NRHM.
After that, group discussed about govt, health services especially in PHC’s and GH. Finally
health services information sheets was distributed to all participants.
After the lunch session tools were introduced to participants, than members were discussed
about tool, and finally they present their group concern, all of remarks noted to clarify.
Than after that PHC’ wise local volunteers were selected as a voluntary based, from that
selection planning also presented as PHC wise and for GH also.
Finally training program was concluded by district coordinator.
In the morning block training workshop inauguration function was conducted. Sharply it was
started at 11.00 am. In Thadaperumbakkam panchayat community hall. Firstly block
chairman spoke about importance of hospital facility, and also need for people monitoring.
And also she shared about her view about functions of PHC’s, particularly she exposed some
positive and also negatives. Than she greets Jeeva jyothi activities like facilitation of village
watch dog committees. After that district councilor spoke about importance of health in
human life and than she greet monitoring members and also facilitating team.
Than Mrs.Pankajam, president of Thadaperumbakkam, expressed her view about working
status of PHC’s. She quoted one experience that was She was went PHC for treatment, but
she did not get proper treatment. Because of doctor unavailability. So she also wants to be a
monitoring member.
After that participants from around 15 villages introduced themselves. Than Mr.Arul-CMP
Block Coordinator explain about the projects. He spokes about importance of monitoring
also.
Than Mr.Ameerkhan explain about Tamilnadu science forum and Makkal Nalvalvu lyakkam
activities and key points about monitoring and also explain govt, health services, and
systems of PHC’s and GH. Like every PHC must have village health and sanitation
committee, for this committee govt, allotted 10.000 rupees as a untie fund. And also every
PHC must have patient’s welfare committee; govt allotted 1 lake per year.
Participant also hearing very interestingly and express their unknowingness and they shared
their interest to doing monitoring.
87 | Pag ?
a
After that PHC doctors were came and greet the monitoring members. Than Dr.Saravana
Kumar spoke about minjur PHC services like ambulance service, 24 hour medical facility
etc..., and also express their view about health services. Than Dr .raj an spoke about the
difficulties in service like he express his inconvenience to go to PHC from his city, and also
he mentioned if 4T m stayed the village, may be my child became illiterate.” After his word
participants were strictly against his view, they want that Doctor should apologize for his
wrong statement.
Than Mr.Devaraj, Dist Coordinator, introduced monitoring tools and explained to the
participants. Than participants were divided as different groups .After that group discussed
and share their views about monitoring tools.
Finally, participants planned their activities for next three months.
88 | P a g e
TIRUVELLORE DISTRICT - POONAMALLI BLOCK
Venue : Thiruninravoor Panchayat office
Date
: 03/01/2008
No. of Participants: 30 members
Poonthamalle block is one of the chosen blocks in Tiruvallur district for implementing the
pilot project of community monitoring and planning. In the Poonthamalle block, the chosen
PHCs are,
1. Nemam
2. Thiruninravoor
3. Thirumalise
The Poonthamalle block is coordinated by ’Pasumai trust’ one of the MNI members in
Tiruvallur district. The workshop was started at 11.00 a.m. Since the Pasumai trust has, good
rapport with Panchayat representatives of this block the panchayat gave their premises to run
this one-day workshop. The special invitees were the chairman and Executive officer of
Thiruninravoor panchayat. In their inaugural address, both of them assured long-term
cooperation to this process.
Soon after the inauguration of the workshop. Ameerkhan from MN I orient the group on
NRHM and community monitoring process. He explained the framework of implementation
and the importance given to community monitoring in the framework. He also explained the
components of the current pilot project.
After this, the group discussed and shared the health related problems they are facing in their
own villages. There were many issues raised by the group include the quality of the health
care services especially the role of the Health Inspector. In many villages, the community
especially in this block did not see the health inspector role.
This exercise emphasizes the importance of local and participatory planning. The group
mentioned that the most of the villages, which covered by the Thiruninravoor PHC, are
located across the railway gate. Since most of the time the gate remain closed crossing the
railway gate is difficult for them. They said the PHC should have located across the gate.
They also shared the ‘Soranchey’ village has many leprosy patients, whom need special
attention.
The medical officer of Thiruninravoor PHC, VHN and health inspector participated in this
workshop. They shared their expectation from community, the difficulties they are facing,
and the facilities available in PHC and assured their cooperation to this process. The
community asked few questions to service providers and got answers from them.
As a last session, the participants divided as 3 groups and they discussed the tools with the
translated tools version. Each group has taken few topics and they discussed the tools among
themselves and presented their opinion on tools. This exercise was to help them to
familiarizing the tools. The workshop closed at 5.p.m.
89 | P a g e
VELLORE DISTRICT WORKSHOP - REPORT
Date : December 22 And 23, 2007
Venue : Conference Hall, Office Of Deputy Director Of Health Services, (Vellore Hud)
Collector Office Complex, Vellore.
Programme Schedule:
Saturday, 22nd
09.00 Am
Registration
10: 30 Am
Welcome Address, Visvanathan, Chair MAN,
KATTUPATTUR PANCHAYAT and Tamil Nadu Science Forum
PRESENDTIAL ADDRESS: Dr.P.CHANDRA,
MEMBER, STATE AND DISTRICT MENTORING TEAM.
INTRODUCTION: AMEER KHAN,
Peoples Health movement, coordinator
Inaugural address: Dr. Rajasekar, Deputy Director,
Health services, Vellore Health HUD,
Special address : Dr. Premkumar, Deputy Director,
Health services, Tirupattur HUD
Felicitation
: Gopal Rajendiran, President
Vellore district Science Forum
Mr. Murguan, Adminstrative officer, DD office, Vellore
Mr. Senthamil Selvan ( Sunday 23rd)
Details of participants:
1. Representatives from NGO
: 15
2. Reprsentatives from PRI
: 15
3. Tamil Nadu Science Forum representatives
: 10
4. Representatives from Government
: 11
District Mentoring committee members
1. Dr. P. Chandra (DAS CBR)
2. Mr. Senthamil Selvan ( TNSF )
3. Dr. K.V. Arulalan ( District coordinator - CMP )
90 | P 3 g s
4. Mrs. Shankari (AIDWA) Vellore
5. Mrs. Maithaly NSS programme officer.
As many delegates had to come, traveling more than 100 kms from tirupattur block, the
meeting got delayed by about x/i hour. The meeting was inaugurated by Vellore health district
deputy director Dr. Rajasekar.
Mr. Visvanathan while welcoming the participants stated, that a cooperative effort is needed
for the monitoring process to be successful.He solicited the support of every one, to make
community realize its rights.
Dr. Chandra said, she has been in active practice for more than 50 years and she is saddened
to see worsening of health care scenario in our country. Though many diseases have been
conquered by nutrition and immunization, many children are deprived of their childhood due
to poverty and illness. Globalisation has worsened the situation.
Unlike other countries there is no direct taxation for health care in India. So health care and
other welfare measures are financed from taxes collected from the poor. Thus the poor are the
major contributors to the treasury due their large numbers. They have not realized their rights.
NRHM has included community monitoring in their programme. This monitoring is a
Government programme and not a programme of individual or certain activists. It is aimed
through this monitoring process People, particularly those below poverty line become aware
of all the services available and their rights to get them.
Mr. Ameer Khan raised several issues which question so called advances of health care in
Tamil Nadu. He asked whether we can be satisfied with this. Poor and their marginalized
have to be made aware of their rights.
In his inaugural speech, he highlighted various achievements which were possible through
NRHM in Vellore HUD.
1. Deliveries which were less than 8 per day have gone more than 38 per day.
2. Cesarean sections are conducted at primary health centers itself.
3. Blood storage facilities are available in selected primary health centers.
4. Prostaglandins are made available for controlling post-partum hemorrhages
5. Anti-D injections are given to needy mothers.
6. Anti Rabies vaccines are also available for the poor at primary health center level
*
Dr. Prem kumar, deputy director of health services spoke of other benefits of NRHM in
Tirupattur block. Still! many poor deprived of proper care. When they seek care from private
sector, they sell their only property increasing their poverty and indebtedness. Hence there is
an urgent need
to improve all sections of public sector health services.
Mr. Gopal Rajendiran of Tamil nadu Science forum discussed the pioneering role in the field
of education and its role to improve health status...
91 | P a g e
Mr. Murugan Adminstrative officer, spoke of keeping the health workers in a satisfied
condition.This he said paved the way of health care delivery system to perform better.
Dr.Arulalan in his vote of thanks said wre cannot shun away from the responsiblites. He
stressed the importance of investing in improving maternal and child health services. He
explained with Dr. Bhuttals criticism of Taj Mahal. If Shajahan, who build Taj Mahal
following Mumtaz post partum hemorrhage, instead of building, if he had concentrated on
promoting the skills of birth attendants like Swedish King of at that time, maternal mortality
would have down thus stabilizing the sub-continent population.
In the post lunch session, Mr. Amir led the discussion and there were 12 panchayat presidents
and rest were related to the field work. They discussed on Health as a right. They expressed
the following draw backs in health services.
1.
Corruption
2.
Rude Behaviour of health care functionaries.
3.
Remuneration offered under various schemes like.
Dr.Muthureddy lakshmi scheme, reaches only a few of the people. BPL. Improper referral
of very sick patients. They concluded that we should give to people as a minimum right to
health. Three blocks are
Kandldli,
Pemampet
Kaniambadi.
and
Members sat separately and each one of them identified the 3 primary health centers and 15
villages were identified in each block.
Villages which were situated from a long distance from PHC and
Villages in which disadvantaged section of the village were living were chosen.
Then each one of them discussed these issues and suggested approaches to monitoring.
DAY 2, December 23rd
SUNDAY
The second day many presidents could not make it as they were supposed to be present in the
villages. The day started with Dr. Chandra welcoming the participants.
Mr. Senthamil selvan of Tamil nadu science forum discussed on rules a field worker should
follow.
Important among them were :
1. They must go with the mindset to learn and not to teach
2. They are the primary beneficiaries not the people
3. They must were simple dress
92 | P 5 g e
4. They must discuss the felt needs of the people
5. They must have code of behavior.
The tools were studied by the participants and were discussed by Dr. Chandra and Dr.
Arulalan. Each page in the tool was discussed in detail. Mrs. Maithali of NSS, DKM
COLLEGE, said she could utilize their volunteers. First the Village description were
discussed. Then Discussion on village women self groups were discussed
Following doubts were raised.
•
How all the untied funds to be used.
•
How to collect data from post natal women and mothers.
•
Issue of bribing was discussed at length and how to record them
•
Refusal of services
People may be afraid to bring the issue to the forum. Local Activists are involved. If the
objective of monitoring is explained to the people they will boldy come with remarks.All
of them demanded the Tamil Version must be ready before block level workshops.The
tentative action plan is as follows.
BLOCK
•
Block level Committee formation
• Meeting of block committee
•
Meeting block officials First round
PHC
•
Committee formation
•
First meeting of the committee
•
Village Committee formaton
•
5 Villages for each PHC
•
Committee meeting, training.
All these process were expected to be completed by February end.
Subsequently action plan was drawn. As soon as tamil tools are available to conduct block
level workshops.
93 P a g e
District Map :
Vellore District
Blocks
10
0
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K;
Shol^Hhu^
30 km
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•
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;
Kahdili
•
© GISNIC - TNSU
94 | P a g e
VELLORE DISTRICT - KANIYAMBADI BLOCK
Date
Sunday, January 6Th
Venae :
Government Boys School
Report:
The meeting was attended by over 32 members
Panchayat presidents
TNSF volunteers
District coordinator
:5
:26
: 1
Mr. Gopal rathinam welcomed the gathering and high lighted the government steps taken for
making all children to attend school. He wanted similar event to take place in health sector
also.
Mr. Visvanathan, president kattuputhur village spoke in detail the efforts taken in his
panchayat which has gained national fame. Similar efforts if taken for NRHM will go a long
way for us toachieve our goals
Dr. Arulalan, spoke about the efforts taken so far
Then Mr. vanamailan spoke about the responsibilities of the field workers
1.
2.
3.
4.
They must be polite
They must realize they are the primary beneficiaries of the programme
People know many things
They must act on the felt needs of the people
First the method to collect from the villages were discussed.
There were 15 villages from 3 primary health centers.
Then each page from the tool was discussed.
Many doubts were raised and were cleared
Panchayat presidents who were present actively participated. They assured full cooperation
will be given for the conduct of the programme:
95 | P 2 g e
VELLORE DISTRICT - PERNAMPET BLOCK
Date
Saturday, January 5th
Venue
Kailasa Giri, Primary School
The Meeting Was Attended By 60 People
Presided By: Dr. Chandra
WELCOME ADDRESS
Block chair man
TNSF
: Dr. Kumar
Dr. Rakhal
: Padmavathy
: Subramaniam
INTRODUCTORY REMARKS:
Dr. Chandra briefly outlined the progress in the past few years in the field of
health care delivery and said globalization is taking heavy toll of the poor people
PRE TEA SESSION:
Dr. Rakhal described how NRHM evolved over the years and how this is an
opportunity for poor people to develop a redressal addressing mechamsm. There is on
punitive intention in this programme.
PRE LUNCH SESSION:
PHC MEDICAL OFFICER spoke of the various benefits obtained under the
national rurual health mission.
All the panchyat members were facilitated.
POST LUNCH SESSION:
MS KUPPAM, NARIAPATTU, MELPATTI are the PHC in this block.
15 Villages were identified and the volunteers who are going to the field discussed in length
about the things they are going to do.
Module content were discussed in detail
POST TEA SESSION
It was decided to take up active collection of data after pongal and share the
data with others.
96 | P a g e
VELLORE DISTRICT - KANDLI BLOCK
Date
Friday, January 4th
Venue
Kamatchiamman Thimmana Mandapam, Housing Board, Tirupattur
Programme:
Welcome Address
Inauguration
Felicitation by
Vote of thanks by
: Dr. P.Chandra
: Dr. Premkumar DD, Tirupattur Health district
: Mr. K. Anbazhgan Vice chairman, Panchayat Union, Kandhili Block.
Palanivel samy
Participants: 54 Nos
20
7
16
2
4
Representatives from health sector
Representatives from PRI
Literacy mission
Self Help group
NGO
Dr. Chandra welcomed the participants. She spoke about the changes taking place in the last
50 years in the field of health care delivery. Small pox was eradicated epidemics of cholera
tamed, still the health and nutrition status of the block are far from satisfactory. Liberisation
globalization and privatization is affecting the agricultural sector and the poor are
marginalized more and more. Improving public health sector services need top priority.
The community monitoring programmed is a government sponsored programmed in which
the civil society helping in monitoring. The process monitoring will make people aware of
the rights and pave the way for full utilization of all services by them. The involvement of
panchachayat raj institution for health of the people. Hence their participation and
involvement was solicited.
Liberisation, privatization and globalization is affecting the poor and the marginalized
Dr.Premkumar DDHS highlighted the rapid improvement of health services after
inauguration of NRHM in the last 2 years. Still the poor are not reached. To meet the
expenses of medical care they borrow or sell their property thereby increasing their indebt
ness. He hoped and wished that the monitoring process will make public aware of the
services available and rapidly improve their utilization. The Female: Male ratio is lowest in
Kandili block. Girls from conception to adulthood prompt attention.
Mr.Palanivelsamy thanked the participants.
3 primary health centers are
Kunichi,
Gajalanaickenpatti, Perampattu.
97 | P a g
5 villages in each phc were selected which were considered to be underserved and with
marginalized people.
Representatives from each village were given sufficient time to express how they are going to
do the work. They identified the following problems. Corruption, Doctors not available,
PHC functioning hours to be from Sam to 4pm., lack of courtesy among health providers, all
eligible beneficiaries from BPL are not receiving from funds from Dr.Muthulakshmi scheme
and others.
The health workers said that their work load is heavy; population allotted for each VHN is
high. On camp days only they are not available in their centers. The tools were discussed in
detail page by page. Many of the workers themselves were not aware of untied benefits and
other benefits.
The PHC and village committees will be formed in the first week of February and they will
be ready for training by end of February and in March it was hoped to take up monitoring.
DETAILS OF PARTICIPANTS
Activity______________ OFFICIALS TNSF
10___
DISTRICT WORKSHOP II
20_________ 16___
KANDILI BLOCK
PERNAMBET________ J______ 22___
26
Nil
KANIAMBADI
SHG
Nil
02
17
Nil
NGO
15__
4___
3___
1
PRI TOTAL
56____
15
7__ 54_____
6__ 56____
32
5
98 | P a g s
ANNEXURE
• INVITATIONS
• PHOTOS
• PAPER CUTTINGS
• BANNERS
• TRAINING MODULES
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(I,
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^BrrgrnrA A^rrdJTLfTsgjjar
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
TOOLS
Pgl
Mobilisation of Communities
The village is the main focus for the community monitoring activities. In a block 15
revenue villages are being included in the first phase of this project. Village is a
heterogeneous entity which has its own dynamics and population groups. In order for the
community monitoring process to be a success, the involvement of the community is very
essential. So instead of pushing the project from outside, we need to work towards the
community owning the project and seeing it as essential for the empowerment of the
village and the betterment of the health services. Therefore mobilisation of the village
communities is an important part of the community monitoring project.
Objective of community mobilization:
1. To make the communities aware of their health related entitlement within NRHM.
2. To have a shared understanding of the health issues of the community.
3. To facilitate the formation or expansion of the Village Health and Sanitation
Committee.
4. Building ownership about public health service.
5. Developing awareness about determinants of health.
Proposed Activities:
(Assumption - the Block level organisation is familiar with the village)
The mobilisation of the villages will include
1. Distributing pamphlets to literate people
2. Putting up posters in the common meeting places of the people (e.g. near temples, wells,
market place, etc.)
3. Infonnal meetings with key people (leaders of CBOs, women leaders, Pradhan, in the
village) to get an idea about
• General layout of the village
• Different social groups in the village and where they stay
• Key health problems of the community
• Key service providers of the area
• Expense related to health problems
• Communities opinion and use of government health facilitites and service
providers
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
TOOLS
Pg-2
4. Village meeting to share findings, share NRHM infonnation and facilitate formation of
VHSC
• Share the Village health services profile in the village,
• Inform community of NRHM and community monitoring in NRHM ( share
pamphlets and posters and leave multiple sets behind in the community
• Elicit interest from members of the community about formation of village
health and sanitation committee
Number of days: Three days have been assumed for mobilisation in the Community
Monitoring proposal. These three days with one community/village need not be in one
contiguous block.
Village Health Services Profile: At the end of the mobilisation process the village health
services profile should be filled. This profile should be used by the facilitators and the
VHSC members to familiarise themselves before they stall with the monitoring process.
The village health services profile will also help in comparing the changes that will be
brought about after the community monitoring process. The expected changes are
improvement in services, increased utilisation of government services and decrease in
health related expenditure.
The format for the village health services profile is given below.
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
Village Health Services Profile
I. Demographic profile
1. Name of the Village and gram panchayat
2. Name of the Block 3. Name of the District
4. Name of the SubCentre
5. Name of the PHC -
6. Name of the hamlets
a)
b)
c)
d)
7. Total Population of the village (approx)
8. Total number of households in the village
9. Caste-wise breakup of households
a. Majority Community
b. Minority Community 1
c. Minority Community 2
d. Minority Community 3
TOOLS
pg. 3
>
NRHM-Services COMMUNITY B ASED MONITORING PROGRAMME
TOOLS
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
II. Information of key people
■
10. Name of Panchayat level members and position-
Name
Position
11. Does the village has any village level gr oups/ organizations? (Note group and leaders’
name)
Group
Leaders
I
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
I
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
TOOLS
Pg-5
III. Information about service providers
(According women. Key Informant, excluded groups)
12. Name of the health providers
a. Name of ANM:
b. Name of village health worker:
c. Name of AWW:
d. Name of Male Health worker:
e. Any other extension worker associated with health related activities
specify):
13. Details of Non-govemment Providers
Available in
Usage
Category of
Hamlets
provider
( names)_________
Herbal healer
1.
2.
1_____________
Exorcist/faith healer
1.
2.
3. _______________
Dais -trained
1.
2.
3. _______________
Dais - Untrained
1.
2.
3. _______________
Pvt doctor
1.
2.
3.
I
I
I
I
(please
Distance from Village
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
TOOLS
Pg-6
Informal pvt.
Doctor
1.
2.
3. ___________
Village Health
Worker
1.
2.
3. ___________
Medical Store
1.
2.
3. ___________
Other provider
1.
2.
3.
14 Information related to time and distance of each health Tacility from the village
Health facility
Distance
Time
Sub Centre_______
PHC____________
CHC
15. Community’s opinion of the services provided by the AWW, ASHA, ANM, PHC and
CHC?
(Take infonnation from Women and excluded groups)
Service
availability
Service provided
AWW
1.
2.
3.
4.
5.
Do you utilise
Problems faced
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
ASHA
ANMSubCentre
PHC
CHC
TOOLS
Pg-7 ;
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
IV. Information of social exclusion & main health problems
16. Does the village face any form of social exclusion or marginalisation? If so, please
explain?
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
TOOLS
Pg-8
1
17. What are the main health problems and illnesses in the village?
In order of commoness ( free list and then rank) (list them from the highest most to the
lowest most)
Women
Children
General
1
2
V. Water & Sanitation facilities
(Women and excluded group)
18
What is the main source of
drinking water in the village?
19
What is the main source of
water for other pur poses such as
cooking and washing?
20 Does the village have toilet
facility?___________________
21 What type of toilet facility you
all have?
If
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
TOOLS
Pg-9
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
VI. Health Expenditure
(Women and Excluded groups, Write what the majority of women say)
22
Which are the diseases that cost the most?
List 5 (including Maternal & child health)
or use prompts for including maternal &
child health?
23
Where did you go for treatment?
24
On what was the money spent the most
(why was it so expensive)? (Tick the option
which the majority say)
25
For the treatment how did you arrange the
money? (Tick the option which the majority
say)
1.
2.
3.
4.
5.
On overall treatment___________
Doctor’s Fee_________
Drugs
__________
Transportation_____________
Time/ daily wages lost due to this
Repeated referrals
I was able to pay of my own
Borrowed from
neighbors/friends/family members
Borrowed from Bank/ SHG loan
Borrowed money from Sahukar/
Mortgage assets
26. Expenditure for childbirth, diarrhea, malaria (or any seasonal/endemic diseases). Write
the amount in range.
Home based care
Delivery
Diarrhoea
Malaria
I
I
1
Hospital based care
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
TOOLS
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
pg-10
)
Conducting Community monitoring at the Village and Facility levels
A. Preparatory activities
1. In a village meeting conduct the formation of the VHSC. If VHSC is already existing in the
village, then promote active participation from weaker sections and CBO/NGO representatives.
2. Block coordinator with help from the block facilitator should arrange for a meeting with the
VHSC members. In the villages where CBO/ NGO have a strong grass root presence other
community members could also be involved. In this meeting, a set of five pamphlets of the service
guarantees that NRHM has promised should be distributed.
3. Ask one or two members of the VHSC to speak about the service availability at the village and
level above and improvements that are necessary'.
4. Describe the process of the community monitoring in the pilot phase and beyond, and its
relevance for the community members.
5. Fix a suitable day for the activities for preparation of the village health report card.
B. Process of Community Monitoring
• The community monitoring process results in the formation of a village health report card and a
facility score card. The report card and the score card give a snapshot of the status of various
health issues prevailing from the village to the district level.
• Village Health Report card and the health facility score card would be broadly based on following
indicators with emphasis on the service guarantees as mentioned in the NRHM.
Table 1
1.
_______________ Themes
Disease Surveillance
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Curative Services___________________
United funds_____________________
Child Health_________________
Quality of Care________________
ASHA community perceptions_____
Adverse Outcome or experience reports
Maternal Health Guarantees__________
Janani Suraksha Yojna_____________
Asha functioning______________
Equity Index
12.
13.
14.
15.
16.
17.
Infrastructure and Personnel______
Equipment and Supplies_________
Service Availability_____________
Unofficial charges____________
Quality of Care_______________
Functioning of Rogi Kalyan Samiti
_______ Source of Information_______
Group Discussion with community
_____________ members_____________
_________ ^do_2______________
_______________ - do -______________
______ Discussion with Women______
______ Discussion with Women______
__
Discussion with Women
Interview and Group discussions
Interview with JSY beneficiary
_______________ -do-_______________
_______ Interview with ASHA_______
Discussion with women from general &
_____ marginalized communities______
Facility Check List_______________
________________ - do -_____________
________
- do -_____________
________________ - do -_____________
____________ Exit Interview
Interview with MO
jvKHM-Services COMMUNITY BASED MONITORING PROGR AMME
TOOLS
usTATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
pg. 11
•
•
•
•
•
I
The frequency of preparing the village report card and health facility score card will be once in
every three months. This report card would be submitted to the PHC Monitoring committee.
CBO/ NGO/ SHG representative in the extended Village Health and Sanitation Committee and
one Panchayat member should be nominated for preparing the village health report card.
Village Health Report card and the health facility score card would be prepared in a span of two
days.
It is strongly recommended that at least for the pilot phase Block level coordinator should be
present to demonstrate each monitoring activity. This would be crucial for equipping community
members to participate in the activity of the Village health Report card, health facility score card
and capacity development of the VHSC members to independently conduct Village level meetings
and the beneficiary interviews. This has relevance beyond the pilot phase.
At the village, the following activities in Table 2 will take place for the preparation of the village
health report card.
Table 2
Beneficiary_______
Five Interviews with
women who have
delivered in the last
three months
Community_______
One Group
discussion with
community members
One Group
discussion with
women__________
One Group
discussion with
marginalized
communities_____
One interview with
the ASHA
Provider_____
One Interview
with PHC
Medical Officer
Observation of
Sub centre using
a checklist
One interview
with CHC
Medical Officer
Five Exit
interviews of the
PHC patients
Observation of
PHC using a
checklist_____
Observation of
CHC using a
checklist
Facility7_______
Five Exit
interviews of the
CHC patients
Details of the various activities and how the responses from the community can be recorded to prepare
village and facility level score cards are given in the following pages.
I
I
I
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
Pg- 12
Activity I - Group Discussion with community members
For the discussion with the community around 15 to 20 community members should be present.
After describing the objective of the meeting and detail discussion on the service guarantees that
are offered in the NRHM, explain about the process of the community monitoring. Explain to the
participants that meeting like this one, is first in the chain of interactions that VHSC would be
doing with the local community in the process of the community based monitoring.
Questions regarding disease surveillance, curative services provided by outreach functionaries and
untied fund should be asked. The questions are given below in the format. Please conduct the
group discussion around the issues mentioned in the format During the meeting the responses can
be recorded in a notebook.
Conclude the meeting by mentioning that some more investigative activities will be conducted in
the village and the results will be shared in a village meeting
Once the meeting is over the responses should be recorded in the format and each response is
scored. The corresponding score has to be written in the column named ‘Score’. Tally the scores.
Disease surveillance (Maximum Score: 8)
S.No ! _____ __ _____________ Questions________
L
i Does MPW visit your village regularly for disinfection of
i water sources?
2.
I Have you found MPW efficient in informing concerned
I authorities about outbreak of malaria, diarrhea etc in your
village?
Response
Evetyone: 2
Some people: 1
None: 0
Everyone: 2
Some people: 1
None: 0
3.
Do you report events like birth and death to MPW?
Everyone: 2
Does MPW proactively approach you for registering vital
events like birth and death?
Some people: I
None: 0______
Everyone: 2
Some people: i
| None: 0
4.
Total
Score
NRHM-Services COMMUNITY BASED MONITORING PROGR AMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
pg. 13
Curative services provided by outreach functionaries (Maximum Score: 8)
S.No J_____________________ Questions________________
U
I Did you receive tablets for fever. cough, diarrhea from
j ANM or ASHA?
2.
Do TB patients in your village are receiving regular
medication from ANM or ASHA?
3=
Do you regularly get anti malarial tablet from ANM or
MPW?
4.
Did ANM or ASHA referred someone to PHC or CHC for
serious illness?
Response
Everyone: 2
Some people: i
None: 0_______
Everyone: 2
Some people: i
None: 0_______
Everyone: 2
Some people: 1
None: 0
Everyone: 2
Some people: 1
None: 0
Score
Response
Everyone 2
Some people: i
None: 0
Everyone: 2
Some people: I
None: 0______
Everyone: 2
Some people: 1
None: 0
Everyone: 2
Some people: I
None: 0
Score
Total
Untied Fund (Maximum Score: 8)
S.No _____________________ Questions___________________
1.
Are you aware that Rs 10000/- is allotted to your VHSC as
an untied fund?
2.
Do you get transportation allowance from the untied fund
for referring serious patients to the PHC7 CHC?
3.
Do you regularly get medicine for simple illnesses at the
j village level from ASHA?
4.
Has there been any awareness drive by VHSC in last three
months?
Total
NRHM-Services COMMUNITY BASED MONITORING PROGR AMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
Pg- 14
)
Activity Ila. Group discussion with women of general village community
In tlie discussion around 10 to 15 women from the dominant village community should be present.
This meeting should be facilitated by the woman representative of the VHSC.
After an initial round of introduction, the participants should be made aware about various
entitlements that NRHM has promised especially in the context of the maternal and child health.
After describing the ob jective of the meeting, explain about the process of the community
monitoring. Explain to the participants that meeting like this one, is first in the chain of
interactions that VHSC would be doing with the local community in the process of the community
based monitoring.
Questions regarding child health, ASHA functioning, quality of care, adverse outcomes and any
other key issues of concern surrounding maternal and child health should be asked. The questions
are given below in the fonnat. Please conduct the group discussion around the issues mentioned in
the format. During the meeting the responses can be recorded in a notebook.
Conclude the meeting by mentioning that some more investigative activities will be conducted in
the village and the results will be shared in a village meeting
Once the meeting is over the responses should be recorded in the format and each response is
scored. The corresponding score has to be written in the column named "Score’. Tally the scores.
Note: The questions for the group discussions with women of the general village community and
marginalized communities are the same. The reason for having two group discussions for the same
issues is to find out if there is a difference in perception and service delivery among the two groups.
The information gathered will also be used to develop an equity index in the score card.
Activity lib. Group discussion with Women of Marginalized Communities
Z In the discussion around 10 to 15 women from the marginalized community of the village should
be present.
This meeting should be facilitated by the woman representative of the VHSC.
After an initial round of introduction, the participants should be made aware about various
entitlements that NRHM has promised especially in the context of the maternal and child health.
z After describing the objective of the meeting, explain about the process of the community
monitoring. Explain to the participants that meeting like this one, is first in the chain of
interactions that VHSC would be doing with the local community in the process of the community
based monitoring.
z Questions regarding child health, ASHA functioning, quality of care, adverse outcomes and any
other key issues of concern surrounding maternal and child health should be asked. The questions
are given below in the format. Please conduct the group discussion around the issues mentioned in
the format. During the meeting the responses can be recorded in a notebook.
Conclude the meeting by mentioning that some more investigative activities will be conducted in
the village and the results will be shared in a village meeting
Once the meeting is over the responses should be recorded in the format and each response is
scored. The corresponding score has to be written in the column named 'Score’. Tally the scores.
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
TOOLS
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
pg-15
Child health (Maximum Score: 10)
S.No
1
2
3
- • •
4
5
Score
Response
Questions________
Yes: 2_______________ _ I
Does the ANM regularly visit your
Irregular: 1_______ ___ _____
village fur immunization?
No: 0
__________ __
<
1
month:
2
____________
When was the last immunization done?
Between 1 to 3 months; 1
> 3 months ago. 0
Yes regularly: 2
Apart from Polio drops is there any'
Yes sometimes: 1 _________
injection given on the arm?
No: 0 ~ ~
Regularly: 2______________ _
Does the AWW inform parents if their
Sometimes to some parents: 1
children are underweight or
No: 0 _______________
malnourished?
Regularly: 2
_______ _
Does the AV/W give advice about diet
Sometimes to some parents: I
and extra food for malnourished
children?
__________ No:0
Total
ASHA functioning ( Maximum Score: 8)
S.No
1
2
3
I!
4
Response
Questions________
__ _____
'
Yes:
2
Does the ASHA provide advice to pregnant women
Irregular: 1
No: 0_______
'
Yes: 2
Does the ASHA accompany women for delivery to
Irregular; I
i hospitals
No: 0
I Does the ASHA organize monthly health day for
Yes: 2
i Irregular: i
i immunization and other health services
| No: 0
~
i Yes: 2
~~
Does the ASHA provide medicines for ordinary
No: O ’
Total
i
■
i
Irregular: 1
problems
i
Score
i
)
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
pg. 16
Quality of Care (Maximum Score: 12)
________ Questions______________
Response
S.No
1
| Are you satisfied with die behaviour of the ANM?
Very Good: 5
Okay: 1
Bad: 0
Very Good: 3
Are you satisfied with the behaviour of the Nurse of
2
the PHC?
i
Okay: 1
i
Bad: 0_______
Very Good: 3
Are you satisfied witii the behaviour of the Doctor at
3
the PHC?
Okay: 1______
Bad: 0
Very Good: 3
Are you satisfied with the services available at the
4
PHC?
Okay: 1______
Bad: 0
I ot al
Score
I
4-
Adverse outcome (Maximum Score: 0)
S.No _______________________ Questions__________
Maternal death (death within 6 weeks of delivery’)
1.
2
Heavy Bleeding - (during labour or soon after delivery )
3.
High fever soon after delivery'
4.
Prolonged labor ( more than one whole day)
5.
Neo natal death ( death within week of delivery)
j______________________________________________
6
! Infant death ( death w-ithin a month of delivery)
Response
Yes: -1
No: 0
Yes: -1
No: 0
Yes: -I___
No:0_
Yes: -1 ~
No.O
Yes: -1
i No: 0
| Yes:-!
[ No: 0
8
Still birth
| Yes: I-
i Any other — specify
jNo:0
| Yes: -1
| No: 0
Total
Score
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
Pg- 17
Key issues of Concern around Maternal and Child Health
Maternal Health
a
1.
2.
3.
Child Health
1.
2.
3.
Any other concerns?
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
pg. 18
)
Activity III. Interview with Beneficiary
The list of the beneficiaries can be gathered in the course of the group discussions.
The beneficiaries are women who have delivered in the last three months, whether in an institution
or at home. The beneficiaries can be selected from both near and remote areas.
Z The beneficiary should be made aware about various entitlements thatNRHM has promised
especially in the context of the maternal and child health.
After describing the objective of the interview, explain about the process of the community7
monitoring. Explain that interview like this one, is first in the chain of interactions that VHSC
would be doing with the local community in the process of the community based monitoring.
Questions regarding maternal health guarantees, janani suraksha yojana, adverse outcomes and
adverse experiences should be asked. The questions are given below in the format. Please conduct
the interview around the issues mentioned in the format During the meeting the responses can be
recorded in a notebook.
Conclude the interview by mentioning that some more investigative activities will be conducted in
the village and the results will be shared in a village meeting
Once the interview is over the responses should be recorded in the format and each response is
scored. The corresponding score has to be written in the column named "Score’. Tally the scores.
Maternal Health Guarantees (Maximum Score: 10)
Janani Suraksha Yojana (Maximum Score: 8)
Questions
S.No
Did ANM register your name after pregnancy was
confirmed?
Did ANM examine your BP and abdomen at least four
times prior to your delivery?
Did ANM give you red tablets?
I.
2.
3.
4.
Apart from red tablets was there any other tablet given to
you?
5.
Did ANM give you a TT injection?
6.
Did ANM examine your blood and urine?
7.
i Has ANM referred you to PHC or CHC tor delivery7?
I
8.
] Has TBA or ASHA attended you for a home delivery? (
I Applicable for home deliveries)
9.
i Has ANM visited you at least once after your delivery?
10.
j Did yotTieceive regular dierifom AWW?
i
Total
Respons
e
Yes. I
No: 0
Yes: 1
No:0
' Yes: 1
No:0
Yes: 1 ~
No:0
Yes: I
No: 0
Yes: 1
No: 0
' Yes: 1
No: 0
| Yes: 1
No: 0
Yes: 1
No: 0
Yes; I
No: 0
Score
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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Pg-19 ,
Questions
S.No
Did you have institutional delivery?
1.
!2-
Did the ASHA accompany you?
3.
Have you received allowance of Rs. 1400/- after delivery in
PHC or CHC? (applicable if delivery is institutional)
4.
If you had home delivery did you receive 500/- ?
5.
Did you have to pay any amount to ANM or in the PHC/
CHC to get this allowance?
___________________
Did you tace any harassment in getting the money?
Response
Yes: i
No: 0
Yes: 1
No: 0
Full: 3 "
Score
Partial: 1
Nil:0
Full: 3
Partial: 1
Nil:0
Yes: -2
No: 0
Yes: -2
No:0
Total
Adverse outcome (Maximum Score: 0)
j
Response Score
Questions______________
S.No
Yes: -1
Maternal death (death within 6 weeks of delivery)
1.
No: 0
2
Heavy Bleeding - (during labour or soon after delivery) Yes:-1
~No: 0~
Yes: -I
High fever soon after delivery
3.
No;0
Yes:-1
Prolonged labor ( more than one whole day)
4.
No. 0
Yes: -1
Neo natal deatii ( death within week of delivery)
No: 0
Yes: -1
Infant death ( death within a month of delivery)
6.
No: 0
Yes: -1
I Still birth
7.
4No: 0
~ Yes:-I
I Any other - specify
8
No: 0
I___________
t'
L_
i
I_____________ —
Totid
1_____
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
pg. 20
Any adverse experience or denial of service (Maximum Score: 0)
Questions_________Res
__ ponse
Yes:-I
Refused treatment at a government health centre
No: 0
Yes.
-1
Referred without providing referral sheet or
No: 0
ambulance support _____________________ ____
Yes:-i
’ Abusive behaviour of staff at government hospital
No: 0
Yes: -1
Health provider asked for money
No: 0
'
Yes:
-1
Any other specify
No: 0
S.No
1.
{2?
3,
4.
5.
Score
■
loiai
jli rtiere is a life threatening adverse outcome or a grevious denial of service please record the
details
Activity IV. Documentation of testimony of denial of health care
Name of patient-
AgeSexAddressDate of interview -
Details of care received at PHC / Hospital
• Location of the PHC / Location and type of Hospital -
• Illness / complaints for which PHC / Hospital was visited
• Total Number of visits to PHC / Hospital for this illness • Date of last visit1. History of last visit in the patients / attendants words (Here we want to collect information regarding the main symptoms of the patient, who gave care and
what kinds of examination, investigation and treatment were given)
•
What were the perceived shortcomings or deficiencies in care? (As perceived by the patient or
attendants)
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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Pg-21
•
!
According to patient, was there any adverse outcome because of deficient care? (Death, disability,
continued or chronic health problem, severe financial loss e.g. major loan or sale of assets)
2. Medical attention received:
• Name of the doctor who attended to you • If the doctor was not available at that time, then who attended to you -
1. Nurse/ANM
2. MPW
3. Pharmacist
4. Any other person, specify
• How long after you reached the PHC / Hospital did the Medical Officer / Doctor attend to you?
• Was examination / treatment / operation delayed or denied because of non-availability of a nurse,
W
doctor or specialist?
• In case of an emergency did the doctor immediately attend to the patient? During hospital stay,
regarding conditions that required immediate care, was the doctor available to immediately attend to
the patient?
• Were nurses or hospital staff available to attend to the patient as and when required?
• Do you think that non-availability of any crucial equipment or supply (oxygen, incubator, anaesthetic
equipment, blood, emergency drugs etc.) adversely affected the quality of care?
• Were all the equipments required for the examination and treatment of the patient available in
*
working condition in the hospital?
Diagnosis- (as told by the doctor)
3. Medicines:
• Did you get all the required medicines at the PHC / Hospital?
9
• Did you have to go to any private medical shop to buy some medicines?
• If so, which medicines you had to buy from private medical shop?
• How much did it cost?
L-
4
• Do you have the prescription? (If yes, obtain a Xerox of the same and attach)
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
Pg- 22
4. Expenditure:
• Case paper / card made - yes/no
• Case paper fee / indoor fees charged
• Did you receive a receipt for the payment made?
• Were you charged excess money at the PHC / Hospital (more than specified rates)?
• If yes, how much excess was charged?
• Did your family have to sell assets (land, cattle, jewelry etc.) or take loans to pay for treatment in the
Govt hospital?
5. Referral:
• Was the patient refused admission or referred to another hospital without giving first aid care?
• If the patient was referred, was ambulance or other vehicle made available for the same?
• Did the Govt, doctor ask you to avail of any private services (e.g. laboratory services, Sonography / X
ray) while you were admitted in the Govt, hospital?
• In case you had to take the patient to a private hospital, which hospital? (Name and address of the
hospital)
• What was the total expenditure on care at the private hospital / private lab or imaging centre?
• Did your family have to sell any assets (land, cattle, jewelry etc.) or take loans to pay for the private
hospital charges?
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
Pg-23
Activity V. Interview with ASHA
The ASHA appointed for the village should be contacted and a suitable time should be taken from
her for the interview.
After describing the objective of the interview, explain about the process of the community
monitoring. Explain that interview like this one, is first in the chain of interactions that VHSC
would be doing with the local community in the process of the community based monitoring.
Questions regarding her role and coordination with AWW and ANM should be asked. The
questions are given below in the format. Please conduct the interview around the issues
mentioned in the format. During the meeting the responses can be recorded in a notebook.
Conclude the interview by mentioning that some more investigative activities will be conducted in
in
the village and the results will be shared in a village meeting
S Once the interview is over the responses should be recorded in the format and each response is
scored. The corresponding score has to be written in the column named ‘Score’. Tally the scores.
If there are problems faced due to lack of support from Health system then subtract 1 point for
each problem faced - maximum subtract 3.
J At the end of the interview, the score of each question has to be added and written at the end of
each format.
ASHA Interview (Maximum Score: 12)
S.No ______ ____________ Questions
1
In collaboration with AWW have you organised a
Health day during last three montiis?
2
Has the ANM or other resource person conducted
any refresher training of ASHA in last three
months? _________________________
3
J Do you provide advice to pregnant women about
I institutional delivery
4
i 5
I Nn- 0
Have all the person you have referred been
attended properly at die PHC/ CHC?
«
Score
Yes: 1
No: 0
1 Did you go with the women in any of the cases?
AU: 2
Some, i
None: 0
tHaVe you referred persons to the PHC/ CHC in the | Yes: 1
i last three months?
7
___ Response
Yes: 1
No: 0
Yes:! _____ _
No:0
Have you received financial incentives according
to norms
Have you faced any problems in getting financial
incentives
Total
Some. I_________
None: 0
Yes fully: 2_____
Yes partially: 1
None. 0_________
No: 2___________
Sometimes: i
Yes many times: 0
i
f
r
11
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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Pg-24
)
What are the problems you are facing
1.
2.
3.
Facility Level Activities
> As mentioned in Table 2, the provider and facility level inputs will be gathered by means of
interviews and facility level checklist
> Village Level: Subcentre observation (using checklist)
PHC Level: PHC observation (using checklist)
5 Exit interviews
1 interview with MO
CHC Level: CHC observation (using checklist)
5 Exit interviews
1 interview with MO
I. Observation
> For the observation the checklist format has to be filled. The checklist for subcentre, PHC and
CHC is given below.
> Each item in the checklist that is present at the facility will get a score of 1. At the end of each
category (infrastructure and personnel, equipments and supplies, service availability), the scores
have to be added and the sum should be written at the end of the score column.
I
I
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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Pg- 25
Facility Checklist - SubCentre
Name of Subcentre -
Name of the Village -
Block -
District -
Please fill this form through direct observation and through interview with staff
Total number of hamlets servedTotal Population-_____________
Distance from the nearest hamlet Distance from the PHC -
________ Infrastructure and Personnel_______
MPW(Fj posted_______________________ ___
MPW ( F) stays in the subcentre or within 1km
MPW (M) posted
-________
MPW (M) stays in the subcentre or within
1km
SC is located in its own premises
Building is in good repair
SC has regular water supply
SC has a functional toilet
~
Subtotail
Equipment and Supplies
Table -1
________ .
Chairs 2
_____________
Examinable table/IUCD table with foam
mattress - 1_______________
Torch with ceil
IUCD Kit
Delivery Kit____________
Fuiictional Stove____________________
r Tub, Mug
Covered container for waste disposal
I Apron_____________________________
| Non electric Autoclave
__
I Instrument sterilizer/boiler
Present
Score
I
1
Present-
i
t
I
T
i
i
i
Score
i
i
j
i
1
j
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Gloves_____ _
CuT
__________
Nirodh
Oral Pills_________
iFA large/small
Bleaching powder
Cotton wool______
Soap and detergent
Subtotal 2
t
I
i
i
t
I
1
L
i
i
Service Availability________________________ j present
ANC services are available at the SC_________
Delivery services are avail able at the SC
Referral slips for difficult delivery is provided
by the SC
—
Immunisation for children are available at the
SC_______________________________________
Treatment for ARI is available at the SC______
Treatment for AGE is available at the SC______
Referral for RT is available at the SC_________
Conventional Contraceptives are available at
the SC________________________________
IUD insertion services are available at the SC
Subtotal 4
Score
F
■
!
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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Pg-27
Facility Checklist - Primary Health Centre
Name of the PHC:
District:
Block:
Please fill this form through direct observation and through interview with staff
Total number of subcentres under the PHC______________________
Total number of villages covered by the PHC____________________
Distance (in Km) between PHC and CHC/ Referral Hospital
Infrastructure and personnel____________ Present
There is regular public transport available
to come upto the PHC
_____________
There is an all weather road leading upto
the PHC____________________ ___________
PHC Is functioning in a Government
building______________________________
Ambulance is in working order__________
The Building of the PHC is reasonably well
maintained
_____ _ _______
There is regular water supply at the PHC
There is regular electric supply or working
back up generator
_________
There are functioning toilets in the PHC
There is a woricingtelephone- in the PHC
All Female HW posted and present_______
All Male HW posted and present
Medical officers posted and present
Female doctor posted in the PHC _______
PHN posted and present
Pharmacist posted and present__________
There is a functioning laboratory_________
Six beds in working condition______ _____
Staff quarters are available for
paramedical staff__________________ Staff quarters are used by paramedical
staff__________________________________
Staff quarters are available for Medical
Officer________________________________
Staff quarters are used by Medical Officer
Subtotal 1
Score
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Pg-28
Equipment and Supplies
Vaccine Carrier________
Present
| Score
B,P, Instrument
i
Auto “Clave/ Steriliser
MTP Suction Aspirator.
Labor Room Eqiiipment
IUD insertion kit
Normal delivery kit
Em OC drugs
i
_________
ORS packets___________
Mounted Lamp
Lubricated Nirodh stock
OC pills stock_________
IUDs stock____________
Tubal rings stock
Iron Folic Acid stock__
Subtotal 2
Service Availability_____________________ Present
Is the primary management of wounds
done at the PHC?________________________
Are minor surgeries like draining of
abscess etc, done at the PHC?_____________
Is Hie primary management of burns done
at the PHC __________
Are antenatal clinics organized by the PHC
regularly_______________________________
Is the facility for normal delivery available
in the PHC for 24 hours ........... .......
Is die blood examination for anemia done
at tile PHe
i
Is the urihe examination for pregnant
women done at the PHC_________________ [
Is the facility for internal examination for I
!
I
gynecological conditions available at the
i
PHC_________________________________ !
Is the treatment for gynecological
disorders like leucorrhoea, menstrual
disorders available at the PHC__________
Is the facility for MTP (abortion) available
at the PHC?___________________________
Subtotal 3
Score
I
1
j
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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pg. 29
Facility Checklist - Community Health Centre
Name of the CHC:
DistnCu
Block:
Please fill this form through direct observation and through interview with staff
Total number of PHC under the CHC
Total number of villages covered by the CHC__________________________
Is this CHC designated as an FRU?__________________________________
Distance of the CHC from the nearest town?
Infrastructure and Personnel_____________ ___ Present
There is regular public transport available to
come upto the CHC__________________________
There is an al! weather road leading upto the
CHC
____________________
Ambulance is in working order_______________
The Building of the CHC is reasonably well
maintained________________________________
There is regular water supply at the CHC
There is regular electric supply or working
back up generator__________________________
There are functioning toilets in the OPP
There are functioning toilets in the wards_____
There is a working telephone in the PHC_______
There are a total of 30 beds in the wards
There is a labour room with delivery table
Operation theater for major surgery______ __
Minor OT____________________________ __
Laboratory __ ____ _____________
Obsteridan/ Gynaecologist posted and present
Anaesthetist posted and present______________
Surgeon posted and present_________________
Laboratory technician posted and present_____
Female doctor posted and present _________
Medical Officers/ Specialists stay on the campus
Subtotal 1
Equipment and Supplies______ ______
Boyles Apparatus in working condition
Filled Oxygen cylinder present
Shadowiess lamp present____________
| Emergency Obstetric drug kit
Present
score
1
1
f
1
Score
i
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Standard Surgical kit
New Bom care kit
Labour room kit
RTI/STI lab kit
IU D insertion kit
Tubal rings________
Subtotal 2
Service Availability_________________________ Present
Does the OPD function daily at the designated
time______________________________________
Are round the clock emergency service
available
Are there patients admitted into the wards at
this time who were admitted as an emergency
Does the CHC provide 24 hour Emergency
Obstetric Care services______________________
Are Caesarian sections conducted in the CHC
Are MTP services provided at the CHC
Are infants needing critical care for illnesses
such as pneumonia, diarrohea treated at the
CHC
_________ __ _________________ _
Does the CHC provide services for Reproductive
Tract Infections (RTls)?_____________________
Subtotal 3
__________________
I
i
Score
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)
II. Exit interview
> The exit interview is taken from those persons who are coming out of the health centre after being
seen by the doctor for their problem.
> After describing the objective of the interview, explain about the process of the community
monitoring. Explain that interview like this one, is first in the chain of interactions that VHSC
would be doing with the local community in the process of the community based monitoring.
> A total of five exit interviews have to be conducted at each level (PHC/CHC). The format of the
exit interview is given below.
> The response to each question is scored. The corresponding score has to be written in the column
named ‘Score’. At the end of the interview the scores of each issue have to be added separately
and the sum should be written at the end of the column ‘Score’.
Name of the PHC/ CHC:
Village name:
Unofficial Charges (Maximum Score: 5)
Questions
S.No
Have you been provided free medicines from tlie
1
hospital ?
2
Have you been asked for any money by the doctor,
nurse or other staff other than fee fur parchi
3
Have you been asked to conduct any tests from
outside?
4
Have you been asked to buy any medicines from
outside?
5
Have you been asked to go to any outside doctor or in
private?
Total
~~
Qua>ihr of Care (Maximum Score: 7)
Questions
S.No
-4
How long did you have to wait for the
doctor to see you?
2
Are you satisfied by the examination and
check-up done by the doctor?
3
How did the doctor and other staff behave
with you ?
4
Did you find the hospital neat and clean?
Totsl
Score
Response
Yes: I ~
No:0
Yes: -1
No: T
Yes: 0
No: 1
Yes: 0
No: i
Yes: 0
No: 1
Score
Response
Did not take much time: 2
Took some time: 1
Took a tong time: 0
Yes: 2
Somewhat: 1
No: 6
Politely: 2
okay:l
rudely or roughly: 0
Yes: 1
| No: 0
1
i
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HI. Interview with PHC/ CHC Medical Officer (MO)
> One interview should be taken of the MO posted in the PHC/CHC.
> After describing the objective of the interview, explain about the process of the community
monitoring. Explain that interview like this one, is first in the chain of interactions that VHSC
would be doing with the local community in the process of the community based monitoring.
> The format of the interview is given below.
> Not all the questions are scored but for the questions that are scored, the corresponding score has
to be written in the column named ‘Score’. At the end of the interview the scores of each issue
have to be added separately and the sum should be written at the end of the column ‘Score’.
1. Ask the MO about the infrastructure, personnel, equipment and supplies and services offered and score
accordingly.
2. Ask the Medical Officer about the Functioning of the Rogi Kalyan Samiti
S.No
1
2
2
4
5
6
7
8
I
9
Response
Questions
j
Yes: 1
Does your facility have a Rogi Kalyan
Samiti?
No: 0_________________
Yes
(< 3 times in 1 yr): 1
How many times has the RKS met since
it was formed?
No: 0
Yes: 1
Does your facility have a patient
charter?
(check)
No: 0_________________
Yes (within last 3 mills). 1
When did the last meeting of the Rugi
Kalyan Samiti take place?
No: 0
Yes: 1
Have you discussed the patient charter
j in any of your RKS meetings?
No: 0
,7
Yes: 1
j Do you have a mechanisni to collect
j feedback from the patients,7
No: 0
j community? (check)_________________ j
' Yes:
i
any feedback been collected and
I discussed at RKS?
No: 0
i What have been the important decisions (1 point for each)
i taken at the RKS about the functioning
! of the hospital?...........................................
■ Total
___________________ i
Expenditure related to RKS funds
Score
I
J
f1
i
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NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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pg-33
10
Step taken tor patient welfare
(
I
11
€
<
Step taken for grievance redressal of patients
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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Pg- 34
Compiling Village and Facility Level Score Cards
Collation of the data in the Village Report Card
The village report card consists of the issue and their status by means of color code. Green
suggests good performing village, yellow suggests there is a cause for concern and Red suggests
that the village is performing bad.
Calculation
To arrive at the color code for each issue, a series of simple calculations are done.
The maternal health guarantees issue is derived from the interview with the beneficiary. So the
number of women interviewed multiplied by 10 (maximum score for this issue) gives us the
denominator against which the total score of the responses will be compared. If the total score is
more than or equal to 75 percent then the color code is green; if the total score is between 50 to 74
percent then the color code is yellow and if the total score is below 50 percent then the color code
is red for the village.
The Janani Suraksha Yojna issue is also derived from the interview with the beneficiary. So
again the calculations are similar. The number of women interviewed multiplied by 8 (maximum
score for this issue) gives us the denominator against which the total score of the responses will be
compared. If the total score is more than or equal to 75 percent then the color code is green; if the
total score is between 50 to 74 percent then the color code is yellow and if the total score is below
50 percent then the color code is red for the village.
The questions relating to child health were asked in the group discussions with
women/marginalized communities. The maximum score is 20. If the total score of the responses is
between 16 and 20 then the color code is green, if the total score is between 10 and 15 then the
color code is yellow and if the total score is between 0 and 9 then the color code is red for the
village.
The disease surveillance, curative services and untied fund issue was taken up in the group
discussions with the community members. The maximum score is 8 for each issue. If the total
score of the responses for each issue is 7 or 8 then the color code is green, if the total score is 5 or
6 then the color code is yellow and if the total score is between 0 to 4 then the color code is red for
the village.
Quality of care and the community perceptions of ASHA issue was taken up in the group
discussions with women/marginalized communities. The maximum score is 24 for quality of care.
If the total score of the responses is between 19 and 24 then the color code is green, if the total
score is between 12 and 18 then the color code is yellow and if the total score is 0 and 11 then the
color code is red for the village.
The maximum score is 16 for community perceptions about ASHA. If the total score of the
responses for each issue is between 13 and 16 then the color code is green, if the total score is
between 8 and 12 then the color code is yellow and if the total score is between 0 and 7 then the
color code is red for the village.
The questioning on the functioning of ASHA were asked in the interview with ASHA. The
maximum score is 12. If the total score of the responses for each issue is between 10 and 12 then
the color code is green, if the total score is between 6 and 9 then the color code is yellow and if the
total score is between 0 and 5 then the color code is red for the village.
3
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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The adverse outcome/experience is just counted in all the forms and the number written in the
report card. There is no color coding.
The issues of concern are also listed out in the report card from the forms.
S.No.
1.
■
t
Issue_________
Maternal Health
Guarantees
2=
Janani Suraksha
Yojna
3.
Child Healui
4.
Disease
Surveillance
5.
Curative Services
6.
United funds
7.
Quality of Care
8.
9.
Community
perceptions of
ASHA
ASHA functioning
10,
Equity Index
Calculation__________
Number of women ^10= N
Interpretation________
> 75% of N Green
50-74% of N -ȴellow
__ .Below-50% ■» Red
Number of women * 8 = N
£ 7 5% of N -> Green
( be carefiil about the negative
50-74% of N-» Yellow
scores)
Below 50%
Red
Total Score - 20
16 - 20 ->Green
10 • 15 Yellow
0-9»Red_______
Total Score - 8
7 - 8 -> Green
5 - 6 ->Yellow
0 - 4 ^Red
Total Score - 8
7-8
Green
5-6 ^Yellow
-0<4"»Red
Total Score - 8
7-8
Green
5 - 6 ->Yellow
0 - 4 “>Red
Total Score - 24
19 - 24 ->Green
12 -18 ->Yeiiow
0-ll^Red
Total Score - 16
13 -16 ->Green
8 -12 ->YeHow
0-7-»Red
Total Score - 12
10 -12 ->Green
6 ■ 9 Yellow
0 - S -»Red
I
(Total score general community < 1 Favourable to
women)/ (Total score
marginalized community
j women)
marglnanzed group
1 No difference
> 1 Unfavourable to
mappnalized group
11.
Adverse
Outcome or
experience
| reports
| Total Score I
I
1_______________
1
NRHM-Seivices COMMUNITY BASED MONITORING PROGRAMME
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Pg-36
Issues of Concern
Maternal Health
1.
2.
3.
Child Health
1.
2
3.
Cumulative Village Report Card
>
" Mch of ,he
j
Name of PHC/Block/District -
Issue
Maternal Health
Guarantees
Janani Suraksha Yojna
Child HealdF
Disease Surveillance
Curative Services
United funds
Quality of Care______
ASHA community
perceptions
[ Asha functioning
Adverse Outcome or
experience reports
No of Villages Green
— —1____
No of Villages
Yellow
No of Villages
Red
1
2
4
t
W:.
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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FACILITY SCORE CARD
> The facility score card is a snapshot of the status of the health facility in the village/block /district.
The color codes display the facility’s level of performance. Green stands for good performance.
Yellow stands for Cause for concern and Red stands for poor performance.
> For the infrastructure and Personnel, Equipment and Supplies and seivice availability issue, the
observation checklist is used. The percentage of the sum of the scores is taken for each issue. If
the score percentage is more than 75 percent of the maximum score then the color code is green; if
it is between 50 to 74 percent then it is yellow and if it is below 50 percent it is red.
> For the unofficial charges issue, the scores of all the five exit interviews at each level is added. If
the sum of the scores is more than 19 then the color code is green; if it is between 13-18 it is
yellow and if it is 12 and below then it is red.
> For the quality of care issue, the scores of all the five exit interviews at each level is added. If the
sum of the scores is more than 28 then the color code is green; if it is between 18 and 28 it is
yellow and if it is below 18 then it is red.
> For the functioning of RKS issue, the scores of the interview is added. If the total score is more
than 7 then the color code is green; if it is between 5 and 7 it is yellow and if it is below 5 then it is
red.
Name of the Facility:
Block:
District:
Issue____________________ | Calculation______ ~
Infrastructure and Personnel | N=Maximum Score
*
K
V
Interpretation
75% of N Green
50% of N> Yellow
i
Below 50% — Red
Equipment and Supplies
I N~Maximum Score
75% of N — Green
50% of N = Yellow
Below
50% = Red
i
'
75%
ofN
= Green
Seivk-e Availability
I N=Maximum Score
50% of N = Yellow
j______________________________ Below 50% — Red
Unofficial charges
| Add points of all the
>19 - Green
I persons interviewed ( max
13- 18 = Yellow
25)________
< 12 = Red________
j Add points of ail the
Quality of Care
>28 Green
j persons interview ( max 35) 18-28= Yellow
Below 18 = Red______
Functioning of Rogi Kalyan | Total Points scored
>7 = Green
Sanuu
5- 7 = Yellow
Below 3 — Red
NRHM-Services COMMUNITY BASED MONITORING PROGRAMME
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Pg-38
J
Cumulative FACILITY SCORE CARD
> After the facility score cards have been formed for each facility, they are collated by the PHC,
block and district level monitoring and planning committees.
> So according to the color code for each issue in each of the facility score card, the greens, yellows
and reds are added at each level.
Type of Facility - SC/ PHC/ CHC
Name of PHC / Block / District
Issue
No of Villages Green
No of Villages
Yellow
No of Villages
Red
Infmstnicture and Personnel
Equipment and Supplies
Service Availability
Unofrlciai charges
Quality of Care
Functioning of Rogi Kalyan
Samiti
4
7
a
Worksheet - 1
NRHM-Sen ices COMMUNITY BASED MONITORING PROGRAMME
Page 3/3
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
BACKGROUND INFORMATION
BLOCK PHC
3)
I)
VILLAGE
1)
2)
3)
4)
5)
2)
1)
2)
3)
4)
5)
3)
1)
2)
3)
4)
5)
Name of district:
VHSC Are you
y/n
working
in the
village?
Do you have Do you have a
good rapport cadre living in the
in village? village? If Yes
Name?
Panchayat
cooperative /
rapport?
Comments
r
r
r
r
4
*
*
«
STATE WORKSHOP & ToT @ Nehru Stadium, Chennai.
I.
ISSUE
SPECIFIC ISSUE
Partners
How many NGOs /
CBOs are involved in
your dist. in project?
Names
3
Govt. Officials
Are you in touch with the
government officials at
Dist. level? Are they
Cooperative?
-DD
- JD
- Proj. Officer & other
PR1 representatives
Are you in touch with the
PRI representatives in the
block/dist? Will they be
cooperative?
ANSWER
*
Worksheet ~ 2
Page 1/4
NRHM-Ser\ ices COMMUNITY BASED MONITORING PROGRAMME
BACKGROUND INFORMATION (NGOs, Officials, PRIs)
t r
Name of district:
COMMENTS
j-
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